Utility module interface

ABSTRACT

A defibrillator system optimizes the timing and manner of applying a defibrillator charge to a patient based upon data provided to the defibrillator from a utility module or one or more external devices. A parameter module on the utility module provides the defibrillator with patient parameter information. Devices external to the utility module may provide the utility module with coaching data that the utility module may pass through to the defibrillator as a proxy to the external devices. The utility module may also provide external devices with patient data that the utility module may pass through to the external devices as a proxy to the defibrillator on a scheduled or other basis. The utility module may additionally provide a reserve of power to enable defibrillators to be used where power is unavailable and to enable defibrillators to deliver multiple charges more readily anywhere, anytime.

CROSS REFERENCE TO RELATED PATENT APPLICATIONS

This patent application may be found to be related to U.S. patentapplication Ser. No. ______, entitled “Utility Module System”, filedcontemporaneously herewith in the name of David Aoyoma et al.; U.S.patent application Ser. No. ______, entitled “Utility Module”, filedcontemporaneously herewith in the name of Barry Curtin et al.; and U.S.patent application Ser. No. ______, entitled “Defibrillator NetworkSystem”, filed contemporaneously herewith in the name of David Aoyama etal.

FIELD

This invention generally relates to external defibrillators.

BACKGROUND

In humans, the heart beats to sustain life. In normal operation, itpumps blood through the various parts of the body. More particularly,the various chamber of the heart contract and expand in a periodic andcoordinated fashion, which causes the blood to be pumped regularly. Morespecifically, the right atrium sends deoxygenated blood into the rightventricle. The right ventricle pumps the blood to the lungs, where itbecomes oxygenated, and from where it returns to the left atrium. Theleft atrium pumps the oxygenated blood to the left ventricle. The leftventricle, then, expels the blood, forcing it to circulate to thevarious parts of the body and from where it returns to the right atriumto start the oxygenation-deoxygenation cycle of the blood all overagain.

The heart chambers pump because of the heart's electrical controlsystem. More particularly, the sinoatrial (SA) node generates anelectrical impulse, which generates further electrical signals. Thesefurther signals cause the above-described contractions of the variouschambers in the heart to occur in the correct sequence. The electricalpattern created by the sinoatrial (SA) node is called a sinus rhythm.

Sometimes, however, the electrical control system of the heartmalfunctions, which can cause the heart to beat irregularly, or not atall. The cardiac rhythm is then generally called an arrhythmia.Arrhythmias may be caused by electrical activity from locations in theheart other than the SA node. Some types of arrhythmia may result ininadequate blood flow, thus reducing the amount of blood pumped to thevarious parts of the body. Some arrhythmias may even result in a SuddenCardiac Arrest (SCA). In an SCA, the heart fails to pump bloodeffectively, and, if not corrected, can result in death. It is estimatedthat SCA results in more than 250,000 deaths per year in the UnitedStates alone. Further, an SCA may result from a condition other than anarrhythmia.

One type of arrhythmia associated with SCA is known as VentricularFibrillation (VF). VF is a type of malfunction where the ventricles makerapid, uncoordinated movements, instead of the normal contractions. Whenthat happens, the heart does not pump enough blood to deliver enoughoxygen to the vital organs. The person's condition will deterioraterapidly and, if not corrected in time, will result in death, e.g. withinten minutes.

Ventricular Fibrillation can often be reversed using a life-savingdevice called a defibrillator. A defibrillator, if applied properly, canadminister an electrical shock to the heart. The shock may terminate theVF, thus giving the heart the opportunity to resume normal contractionsin pumping blood. If VF is not terminated, the shock may be repeated,often at escalating energies.

A challenge with defibrillation is that the electrical shock must beadministered very soon after the onset of VF. There is not much time todo this since the survival rate of persons suffering from VF decreasesby about 10% for each minute the administration of a defibrillationshock is delayed. After about 10 minutes the rate of survival for SCAvictims averages less than 2%.

The challenge of defibrillating early after the onset of VF is being metin a number of ways. First, for some people who are considered to be ata higher risk of VF or other heart arrythmias, an ImplantableCardioverter Defibrillator (ICD) can be implanted surgically. An ICD canmonitor the person's heart, and administer an electrical shock asneeded. As such, an ICD reduces the need to have the higher-risk personbe monitored constantly by medical personnel.

Regardless, VF can occur unpredictably, even to a person who is notconsidered at risk. As such, VF can be experienced by many people wholack the benefit of ICD therapy. When VF occurs to a person who does nothave an ICD, they collapse, because the blood flow has stopped. Theyshould receive therapy quickly after the onset of VF or they will die.

For a VF victim without an ICD, a different type of defibrillator can beused, which is called an external defibrillator. External defibrillatorshave been made portable, so they can be brought to a potential VF victimquickly enough to revive them.

During VF, the person's condition deteriorates because the blood is notflowing to the brain, heart, lungs, and other organs. The blood flowmust be restored, if resuscitation attempts are to be successful.

Cardiopulmonary Resuscitation (CPR) is one method of forcing blood toagain flow in a person experiencing cardiac arrest. In addition, CPR isthe primary recommended treatment for some patients with some kinds ofnon-VF cardiac arrest, such as asystole and pulseless electricalactivity (PEA). CPR is a combination of techniques that include chestcompressions to force blood circulation, and rescue breathing to forcerespiration.

Properly administered CPR provides oxygenated blood to critical organsof a person in cardiac arrest, thereby minimizing the deterioration thatwould otherwise occur. As such, CPR can be beneficial for personsexperiencing VF, because it slows down the deterioration that wouldotherwise occur while a defibrillator is being retrieved. For patientswith an extended down-time, survival rates are higher if CPR isadministered prior to defibrillation.

Advanced medical devices may be used to assist the CPR process bycoaching a rescuer who performs CPR. For example, a medical device canissue instructions, and even prompts, for the rescuer to perform CPRmore effectively.

While some advanced medical devices provide coaching, defibrillatoroperators may benefit from additional coaching.

BRIEF SUMMARY

The present description gives instances of devices, systems, softwareand methods, the use of which may help overcome problems and limitationsof the prior art.

A utility module is disclosed for enhancing coaching of a defibrillator.The defibrillator may include an energy storage device for storing anelectrical charge; a defibrillation port; a display; a defibrillatorprocessor configured to control the display and when an electricalcharge is applied to the defibrillation port for defibrillating apatient; and a defibrillator data connect. The utility module mayinclude a parameter module configured to detect a parameter of apatient; a module processor configured to control the parameter module;a power source; and a power outlet configured to providing an electricalcharge to a defibrillator when connected to the power connect of thedefibrillator.

In another embodiment, the utility module may further include acommunication module configured to transmit data from the utility moduleand the module processor may be configured to control the communicationmodule. The communication module may enable wired, such as by RS232,USB, or other wired transmission, and/or wireless communication betweenthe defibrillator and one or more external devices. The module processorof the utility module further controls data communications between theutility module and the defibrillator.

An illustrative method for enhancing a defibrillation process involvinga defibrillator including an energy storage device for storing anelectrical charge and a defibrillator processor may include defining areceptacle in a first utility module for receipt of a module forperforming a predetermined functionality in an electrical connectionconfigured to enable data communication between the functionality moduleand the first utility module. The functionality module may be insertedinto the receptacle to enable the data communications between thefunctionality module and the first utility module. The first utilitymodule may be connected to a defibrillator to enable data in the datacommunications from the functionality module to the first utility moduleto be received by the defibrillator.

These and other features and advantages of this description will becomemore readily apparent from the following Detailed Description, whichproceeds with reference to the drawings, in which:

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an illustrative diagram of a scene showing the use of anexternal defibrillator to save the life of a person according to thisdisclosure.

FIG. 2 is a table listing two illustrative types of the externaldefibrillator shown in FIG. 1, and who they might be used by.

FIG. 3 is a diagram showing components of an external defibrillator,such as the one shown in FIG. 1, configured in an illustrativeembodiment according to this disclosure.

FIG. 4 shows a functional diagram of an illustrative defibrillatorsystem of this disclosure.

FIG. 5 shows an illustrative embodiment of the utility module of moduleshown in FIG. 4.

FIG. 6 is a enlarged view of the parameter module included in theutility module shown in FIG. 5.

FIG. 7 is an enlarged view of the Wi-Fi Module included in the utilitymodule shown in FIG. 5.

FIG. 8 is an enlarged view of the fan controller IC included in theutility module shown in FIG. 5.

FIG. 9 shows an embodiment of the indicator panel included in theutility module shown in FIG. 5.

FIG. 10A shows an illustrative embodiment of an electrical circuitconfiguration for the utility module of FIG. 5 of this disclosure.

FIG. 10B shows an illustrative utility module of FIG. 5 with a modulardesign that may be readily scalable in performance by the inclusion ofparameter or other module cartridges after manufacture to provide abundled utility module.

FIGS. 11, 12, 13 show illustrative examples of a display of certaininformation that may be displayed on a display of the defibrillatorshown in FIG. 4 for the purpose of coaching the user on the use of thedefibrillator when connected to the utility module in accordance withthe disclosed system.

FIG. 14 shows an illustrative embodiment of another system of thisdisclosure employing the defibrillator system of FIG. 4 in a network.

FIG. 15 shows a plurality of defibrillators that may be electricallyconnected to a utility module of FIG. 4 of this disclosure to providedata communication links and power links between the defibrillators andthe utility module in order to enable the utility module to coach aplurality of defibrillators contemporaneously.

FIG. 16 shows an illustrative range of services that a network mayprovide the utility module in supporting the user of the defibrillatorin the defibrillator system of FIG. 14.

FIG. 17 illustrates the defibrillator system of FIG. 4 configured tocreate a bidirectional communication link with each of a server and anevent agent/application computer.

FIG. 18 illustrates the defibrillator system of FIG. 4 configured tocreate a bidirectional communication link between the utility module andan external client utility module and a bidirectional communication linkbetween the client utility module and an external utility.

FIG. 19 illustrates the use of a utility module of FIG. 4 of adefibrillator system 400 in engaging a network comprising a server and aclient in connection with coaching a user of the defibrillator.

FIG. 20 shows an illustrative data communication system of thisdisclosure comprising a data interface for enabling communicationbetween a utility module of FIG. 5 and a defibrillator and a serialinterface for enabling communication between the utility module andexternal devices.

FIG. 21 shows a standard OSI module that may be used as described inthis disclosure to provide the data interface of FIG. 20 of thisdisclosure.

FIG. 22 illustrates a PPP Protocol for the Data Link Layer according tothis invention.

FIG. 23 shows a process by which the PPP LCP of the PPP Protocol of FIG.22 may be configured for setting up, maintaining, and terminating thelink between devices such as the defibrillator and the utility moduleand between the utility module and an external device when the utilitymodule is acting as proxy for the external device in connection withcommunications between the external device and the defibrillator.

FIG. 24 shows illustrative data links 1270 using the hardware andsoftware architecture 1100 of FIG. 21.

FIG. 25 further illustrates the operation of a command on the externalserial port and more specifically, the operation of the command in acommunication session occurring between the utility module of FIG. 5 anda defibrillator.

FIG. 26 shows a possible relationship events for user power on of adefibrillator that is in electrical connection with a utility module ofFIG. 5 of this disclosure.

FIG. 27 shows an illustrative communication sequence between the utilitymodule of FIG. 5 of this disclosure and the defibrillator.

FIGS. 28A,B are an illustrative functional diagram of FIG. 5 furthershowing the power management system of this disclosure. FIGS. 28A, B arecollectively referred to herein as FIG. 28.

FIG. 29 is an isometric view of a defibrillator and a utility module ofthis disclosure having a back bridge.

FIG. 30 is an exploded view of an assembly of a defibrillator and aplurality of stacked utility modules to provide a bundled utility moduleaccording to this disclosure.

FIG. 31 is an exploded view of a utility module and back bridge of thisdisclosure, showing details thereof.

FIG. 32 is a top isometric view of a top portion of a back bridge withdata and power connectors for connection with a defibrillator accordingto this disclosure.

FIG. 33 depicts a first utility module electrically connected withadditional utility modules for bidirectional communication with theadditional modules and which are powered from the first utility moduleto provide a bundled utility module.

FIGS. 34A-34D depicts several embodiments of a front panel of a utilitymodule of this disclosure.

FIG. 35 is a flowchart for assembly and connection of one or moreutility modules with a defibrillator for use in coaching thedefibrillator.

DETAILED DESCRIPTION

FIG. 1 is a diagram of a defibrillation scene showing the use of anexternal defibrillator to save the life of a person according to thisdisclosure. As shown, a person 82 is lying on his back. Person 82 couldbe a patient in a hospital, or someone found unconscious, and thenturned over onto his back. Person 82 is experiencing a condition intheir heart 85, which could be Ventricular Fibrillation (VF).

A portable external defibrillator 100 has been brought close to person82. At least two defibrillation electrodes 104, 108 are typicallyprovided with external defibrillator 100, and are sometimes calledelectrodes 104, 108. Electrodes 104, 108 are coupled together withexternal defibrillator 100 via respective electrode leads 105, 109. Arescuer (not shown) has attached electrodes 104, 108 to the skin ofperson 82. Defibrillator 100 is administering, via electrodes 104, 108,a brief, strong electric pulse 111 through the body of person 82. Pulse111, also known as a defibrillation shock, also goes through heart 85,in an attempt to restart it, for saving the life of person 82.

Defibrillator 100 can be one of different types, each with differentsets of features and capabilities. The set of capabilities ofdefibrillator 100 is determined based upon who would use it and whattraining they would be likely to have. Examples are now described.

FIG. 2 is a table listing two typical types of external defibrillators,and who they are primarily intended to be used by. A first type ofdefibrillator 100 is generally called a defibrillator-monitor, becausethe defibrillator part is typically formed as a single unit with apatient monitor part. A defibrillator-monitor is sometimes calledmonitor-defibrillator. A defibrillator-monitor is intended to be used bypersons in the medical profession, such as doctors, nurses, paramedics,emergency medical technicians, etc. who may be trained to providemedical treatment to the patient during a defibrillation process basedupon information provided by the monitor. Such a defibrillator-monitoris intended to be used in a pre-hospital or hospital scenario.

The defibrillator part may be dedicated to a particular mode ofoperation. Alternatively, the defibrillator part may be configured tooperate in more than one modes of operation. One mode of operation ofthe defibrillator part may be that of an automated defibrillator, whichcan determine whether a shock is needed and, if so, charge to apredetermined energy level and instruct the user to administer theshock. Another mode of operation may be that of a manual defibrillator,where the user determines the need and controls administering the shock.In this embodiment, one illustrative defibrillator is configured toenable both automated defibrillation and manual defibrillation modes ofoperation depending upon the selection of the user. As a patientmonitor, the device has features additional to what is minimally neededfor mere operation as a defibrillator. These features can be formonitoring physiological indicators of a person in an emergencyscenario. These physiological indicators are typically monitored assignals. For example, these signals can include a person's full ECG(electrocardiogram) signals, or impedance between two electrodes.Additionally, these signals can be about the person's temperature,non-invasive blood pressure (NIBP), arterial oxygen saturation/pulseoximetry (SpO2), the concentration or partial pressure of carbon dioxidein the respiratory gases, which is also known as capnography, and so on.These signals can be further stored and/or transmitted as patient data.

A second type of external defibrillator 100 is generally called an AED,which stands for “Automated External Defibrillator”. An AED typicallymakes the shock/no shock determination by itself, automatically. Indeed,it can sense enough physiological conditions of the person 82 via onlythe shown defibrillation electrodes 104, 108 of FIG. 1. In its presentembodiments, an AED can either administer the shock automatically, orinstruct the user to do so, e.g. by pushing a button. Being of a muchsimpler construction, an AED typically costs much less than adefibrillator-monitor. As such, it makes sense for a hospital, forexample, to deploy AEDs at its various floors, in case the moreexpensive defibrillator-monitor is more critically being deployed at anIntensive Care Unit, and so on.

AEDs, however, can also be used by people who are not trained in themedical profession. More particularly, an AED can be used by manyprofessional first responders, such as policemen, firemen, etc. Even aperson with only first-aid training can use one. And AEDs increasinglycan supply instructions to whoever is using them.

AEDs are thus particularly useful, because it is so critical to respondquickly, when a person suffers from VF. Often, the people who will firstreach the VF sufferer may not be in the medical profession.

Increasing awareness of the short survival time of a patientexperiencing a VF, has resulted in AEDs being deployed more pervasivelyin public or semi-public spaces, enabling members of the public to useone provided they have obtained first aid and CPR/AED training. In thisway, defibrillation can be administered sooner after the onset of VF, tohopefully be effective in rescuing the person.

There are additional types of external defibrillators, which are notlisted in FIG. 2. For example, a hybrid defibrillator can have aspectsof an AED, and also of a defibrillator-monitor. An illustrative examplemay be an AED provided with an ECG monitoring capability.

FIG. 3 is a diagram showing components of an external defibrillator 300configured in an illustrative embodiment according to this disclosure.These components can be configured, for example, in externaldefibrillator 100 of FIG. 1. Plus, these components of FIG. 3 can beprovided in a housing 301, which is also known as casing 301.

External defibrillator 300 is intended for use by a user 380, who wouldbe the rescuer. Defibrillator 300 typically includes a defibrillationport 310, which may be configured as a socket (not shown) in housing301. Defibrillation port 310 includes nodes 314, 318. Defibrillationelectrodes 304, 308, which can be similar to electrodes 104, 108 in FIG.1, can be plugged into defibrillation port 310, so as to make electricalcontact with nodes 314, 318, respectively. It is also possible thatelectrodes can be hard-wired to defibrillation port 310, etc. Eitherway, defibrillation port 310 can be used for guiding to person 82 viaelectrodes an electrical charge that has been stored in defibrillator300, as discussed below.

If defibrillator 300 is actually a defibrillator-monitor, as wasdescribed with reference to FIG. 2, then it will typically also have anECG port 319 in housing 301, for plugging in ECG leads 309. ECG leads309 can help sense an ECG signal, e.g. a 12-lead signal, or a signaltaken from a different number of leads. Moreover, adefibrillator-monitor could have additional ports (not shown), andanother component 325 for the above described additional features, suchas for receipt of patient signals.

Defibrillator 300 also includes a measurement circuit 320. Measurementcircuit 320 receives physiological signals from ECG port 319, and alsofrom other ports, if provided. These physiological signals are sensed,and information about them is rendered by circuit 320 as data, or othersignals, etc.

If defibrillator 300 is actually an AED, it may lack ECG port 319.Measurement circuit 320 can obtain physiological signals in this casethrough nodes 314, 318 instead, when defibrillation electrodes 304, 308are attached to person 82. In these cases, a person's ECG signal can besensed as a voltage difference between electrodes 304, 308. Plus,impedance between electrodes 304, 308 can be sensed for detecting, amongother things, whether these electrodes 304, 308 have been inadvertentlydisconnected from the person.

Defibrillator 300 also includes a processor 330. Processor 330 may beimplemented in any number of ways. Such ways include, by way of exampleand not of limitation, digital and/or analog processors such asmicroprocessors and digital-signal processors (DSPs); controllers suchas microcontrollers; software running in a machine; programmablecircuits such as Field Programmable Gate Arrays (FPGAs),Field-Programmable Analog Arrays (FPAAs), Programmable Logic Devices(PLDs), Application Specific Integrated Circuits (ASICs), anycombination of one or more of these, and so on.

Processor 330 may include a number of modules. One such module can be adetection module 332, which senses outputs of measurement circuit 320.Detection module 332 can include a VF detector. Thus, the person'ssensed ECG can be used to determine whether the person is experiencingVF.

Another such module in processor 330 can be an advice module 334, whicharrives at a piece of instructional advice based on outputs of detectionmodule 332. Advice module 334 can include a Shock Advisory Algorithmresiding in a memory unit (not shown) in the advice module forinstructing the processor to implement decision rules, etc.Alternatively, the Shock Advisory Algorithm may reside in part or inwhole on a memory 338 of the defibrillator. The instruction to theprocessor can be to shock, to not shock, to administer other forms oftherapy, and so on. If the instruction to the processor is to shock, insome external defibrillator embodiments, the processor is configured toreport that instruction to the user via user interface 370, and toprompt the user to do it. In other embodiments, the processor may beconfigured to execute the instructional advice, by administering theshock. If the instructional advice is to administer CPR, the processormay be configured to enable defibrillator 300 to issue prompts toadminister CPR, etc.

Processor 330 can include additional modules, such as module 336, forother functions. In addition, if other component 325 is provided, it maybe operated in part by processor 330 or by another processor.

Defibrillator 300 optionally further includes the memory 338, which canwork together with processor 330. Memory 338 may be implemented in anynumber of ways. Such ways include, by way of example and not oflimitation, nonvolatile memories (NVM), read-only memories (ROM), randomaccess memories (RAM), any combination of these, etc. Memory 338, ifprovided, may include programs containing instructions for execution byprocessor 330 or other processors that may be included in the externaldefibrillator. The programs provide instructions for execution by theprocessor 330, and can also include instructions regarding protocols anddecision making analytics, etc. that can be used by advice module 334.In addition, memory 338 can store prompts for user 380, etc. Moreover,memory 338 can store patient data.

Defibrillator 300 may also include a power source 340. To enableportability of defibrillator 300, power source 340 typically includes abattery. Such a battery is typically implemented as a battery pack,which can be rechargeable or not. Sometimes, a combination is used, ofrechargeable and non-rechargeable battery packs. Other embodiments ofpower source 340 can include an AC power override, whereby AC power,instead of power from power source 340 is delivered to an energy storagemodule 350 when AC power is available. In some embodiments, power source340 is controlled by processor 330.

Defibrillator 300 additionally includes the energy storage module 350.Module 350 is where electrical energy is stored in preparation for asudden discharge to administer a shock. The charge to module 350 frompower source 340 to the right amount of energy can be controlled byprocessor 330. In typical implementations, module 350 includes one ormore capacitors 352, and may include other circuitry.

Defibrillator 300 moreover includes a discharge circuit 355. Circuit 355can be controlled to permit the energy stored in module 350 to bedischarged to nodes 314, 318, and thus also to defibrillation electrodes304, 308. Circuit 355 can include one or more switches 357. Those can bemade in a number of ways, such as by an H-bridge, and in other ways wellknown in the art.

Defibrillator 300 further includes the user interface 370 for user 380.User interface 370 can be made in any number of ways. For example,interface 370 may include a screen, to display a parameter of a patientthat is detected and measured, provide visual feedback to the rescuerfor their resuscitation attempts, and so on. Interface 370 may alsoinclude a speaker, to issue voice prompts, etc. Interface 370 mayadditionally include various controls, such as pushbuttons, keyboards,and so on. In addition, discharge circuit 355 can be controlled byprocessor 330, or directly by user 380 via user interface 370, and soon.

Defibrillator 300 can optionally include other components. For example,a communication module 390 may be provided for communicating with otherdevices. Such communication can be performed wirelessly, or via wire, orby infrared communication, and so on. In this way, data can becommunicated from the defibrillator 300 to external devices, such aspatient data, incident information, therapy attempted, CPR performance,and so on.

Having thus introduced background on the general operation of adefibrillator, we now turn to features that are provided by thisdisclosure.

FIG. 4 shows a functional diagram of a defibrillator system 400comprising: a defibrillator 410 and a utility module 455. Defibrillator410 comprises an energy storage device 415 for storing an electricalcharge; a defibrillation port 420; a display 425; a defibrillatorprocessor 435 configured to control the display 425 and when anelectrical charge is applied to the defibrillation port 420 fordefibrillating a patient; a memory 430; and a defibrillator data connectport 440. Defibrillator 410, and its various components, can be asalready described with reference to FIG. 3 above.

Utility module 455 in FIG. 4 illustratively comprises a parameter module460 configured to detect a parameter of a patient; a communicationmodule 490 configured to transmit data from the utility module; a dataoutlet 475 configured to engage the defibrillator data connect port 440of the defibrillator 410 for transmitting data to or receiving data fromthe defibrillator 410; and a module processor 480 configured to controlthe parameter module 460 and the communication module 490 and a memory485. While the illustrative embodiment includes both the parametermodule 460 and the communication module 490, it will be appreciated thatother embodiments may include the parameter module without thecommunication module; or may include the communication module withoutthe parameter module. In other words, each of the parameter module andthe communication module may be used alone or in combination with theother module or still other modules in the disclosed utility module.

In an alternative embodiment, the defibrillator 410 may further includea power connect 445 and the utility module may further include a poweroutlet 470 configured to engage the power connect 445 of thedefibrillator 410 for providing an electrical charge to thedefibrillator 410 from a power source 465. In another alternativeembodiment, the utility module is further provided with the power source465.

The display 425 of the defibrillator 410 may be a visual display capableof displaying data transmitted from defibrillator processor 435.Displays for use with this disclosure may include an LCD screen, ane-paper display, or other bi-stable display, a CRT display or any othertype of visual display.

The defibrillator data connect port 440 may illustratively be a hardwarebased data connector configured to connect with the data outlet 475 ofthe utility module as described below. Alternatively, the defibrillatordata connect port 440 may be one or more ports that allow bidirectionalflow of data between the defibrillator and the utility module.Illustratively, the defibrillator data connect port is an RS232 socketconnector configured for connection to the data outlet 475 in a wiredconnection. Illustratively, the RS232 socket connector may connect withan RS232 plug connector forming the data outlet 475. Alternatively, thedata outlet 475 may also be a socket connector and the RS232 socketconnector of the defibrillator data connect port may be adapted toconnect to the socket connector of the data outlet, such as through acable terminating on either end with a plug connector. As anotherexample, each of the defibrillator data connect port and the data outletmay be plug connectors that are adapted to be connected through a cableterminating on either end with a socket connector. Other connectors maybe used for defibrillator data connect port 440 as are well known in theart.

While the foregoing disclosure of the defibrillator data connect port isillustrative based on the RS232 standard, it will be appreciated thatdefibrillator data connect port may include a USB or other wireconnector. In addition, the defibrillator data connect port may be awireless connector for wireless connection with the data outlet 475. Inaddition, while the illustrative defibrillator data connect port isdisclosed as hardware based, it will be appreciated that the hardwaremay be configurable by software in which case the hardware and softwaretogether may together form the defibrillator data connect port of thisdisclosure.

The power connect 445 of the defibrillator may illustratively be ahardware based power connector configured to connect with the poweroutlet 470 of the utility module as described below. Alternatively, thepower connect may be one or more power connectors that allow power toflow between the defibrillator and the utility module. Illustratively,the power connect is a plug connector configured for connection to thepower outlet 470 configured as a socket connector in a wired connection.Alternatively, the power connect 445 may also be a socket connector andthe socket connector of the power connect may be adapted to connect tothe socket connector of the power outlet through a cable terminating oneither end with a plug connector. As another example, each of the powerconnect 445 of the defibrillator and the power outlet of the utilitymodule may be plug connectors that are adapted to be connected through acable terminating on either end with a socket connector. Otherconnectors may be used for power connect 445 as are well known in theart. In addition, while the power connect 445 is disclosed as hardwarebased, it will be appreciated that the hardware may be configurable bysoftware in which case the hardware and software together may togetherform the power connect 445 of this disclosure.

Referring now to the components that may make up the utility module 455,the parameter module can be any monitor configured to detect a parameterof a patient. The patient parameter may include one or more of thefollowing measurements: a measurement of CO₂ exhaled by a patient; anelectrical activity of the heart of a patient; an exchange of airbetween the lungs of a patient and the atmosphere; a pressure of theblood in a patient; a temperature of a patient; an oxygen saturation inthe blood of a patient; a chest compression of a patient; an image ofthe internal structure of a patient; an oxygen saturation in the bloodin the brain of a patient; the acidity or alkalinity of fluids in apatient; or other patient parameter.

The patient parameter of the CO₂ exhaled by a patient may be measuredusing capnography techniques. The patient parameter of the electricalactivity of the heart of a patient may be measured using ECG techniques.The patient parameter of the exchange of air between the lungs of apatient and the atmosphere may be measured using ventilation techniques.The patient parameter of the measurement of the pressure of the blood ina patient may be measured using non-invasive blood pressure measurementtechniques or invasive blood pressure measurement techniques. Thepatient parameter of the temperature of a patient may be measured usingtemperature measurement techniques. The patient parameter of the oxygensaturation in the blood of a patient may be measured using pulseoximeter techniques or tissue oximetry techniques. The patient parameterof the chest compression of a patient may be measured using chestcompression detection and feedback techniques. The patient parameter ofthe image of the internal structure of a patient may be measured usingultrasound measurement techniques. The patient parameter of the oxygensaturation in the blood in the brain of a patient may be measured usingcerebral oximetry techniques. The patient parameter of the acidity oralkalinity of fluids in a patient may be measured using non-invasive pHmeasurement techniques. These and other techniques and modules forgenerating the foregoing and other kind of patient parameter data foruse with this disclosure are well known in the art.

Data outlet 475 is configured to engage the defibrillator data connectport 440 of the defibrillator for transmitting data to or receiving datafrom the defibrillator. The data outlet 475 may be one or more portsthat allow bidirectional flow of data between the utility module and thedefibrillator. Illustratively, the data outlet 475 is an RS232 plugconnector configured for connection to the illustrative socket connectorof the defibrillator data connect port 440 as described above in a wiredconnection.

Alternatively, the data outlet 475 may also be a socket connectoradapted to connect to the socket connector of the defibrillator througha cable terminating on either end with a plug connector. As anotherexample, each of the data outlet 475 and the defibrillator data connectport 440 may be plug connectors that are adapted to be connected througha cable terminating on either end with a socket connector. Otherconnectors may be used for data outlet 475 as are well known in the art.In addition, the data outlet 475 may be a wireless connector forenabling a wireless connection with the defibrillator data connect port440. While the data outlet is disclosed as hardware based, it will beappreciated that the hardware may be configurable by software in whichcase the hardware and software together may together form the dataoutlet of this disclosure. When the data outlet receives and engages thedefibrillator data connect port, a data communication link 441 isestablished for the bidirectional flow of data between the utilitymodule and the defibrillator.

Communication module 490 is hardware and software configured to transmitdata from the utility module. Illustratively, the communication module490 is configured to transmit data from the utility module to anexternal utility 494. The external utility 494 may be a computer, alaptop, a server, a mobile computing device, or other computing device.Alternatively, the utility module may transmit data over thecommunication module 490 to the defibrillator 410. The bidirectionaltransmission of data from out of and to the utility module through thecommunication module 490 may be separate from and additional to thebidirectional flow of data occurring through the data outlet 475 and thedefibrillator data connect port 440 of the utility module and thedefibrillator, respectively, over the data communication link 441described above. Alternatively, the data outlet 475 and thedefibrillator data connect port 440 may be functionality that isprovided by the communication module 490.

As illustrated in FIG. 4, the external utility 494 is likewise providedwith a communication module 495. Together, the communication module 490,495 of the utility module 455 and the external 495, respectively, enablea communication link 493 to be established between the utility moduleand the external utility for enabling the bidirectional flow of databetween the two devices.

In an illustrative embodiment, the communication module may comprise awireless module 491 and/or a module data connect port 492 as shown inFIG. 4 and described in greater detail below. The wireless module mayillustratively be a Wi-Fi module. Alternatively, the wireless module 491may be a blue tooth module, a CDMA module, or any other communicationmodule that enables a wireless communication link for the bidirectionalflow of data between devices wirelessly. The module data connect port492 may be a hardware based data connector configured to connect with adata outlet of the external utility 494 (not shown) as described laterbelow. The module data connect port 492 may be one or more ports thatallow bidirectional flow of data between the utility module and theexternal utility 494. Illustratively, the module data connect port is anRS232 plug connector configured for connection to a socket connector(not shown) of the external utility 494 in a wired connection.Alternatively, the module data connect port may also be a socketconnector and the RS232 socket connector of the external utility may beadapted to connect to the socket connector of the utility module througha cable terminating on either end with a plug connector. As anotherexample, each of the module data connect port and the connector of theexternal utility may be plug connectors that are adapted to be connectedthrough a cable terminating on either end with a socket connector. Otherconnectors may be used for module data connect port 492 as are wellknown in the art.

While the foregoing disclosure of the module data connect port isillustrative based on the RS232 standard, it will be appreciated thatmodule data connect port may include a USB or other wire connector. Inaddition, while the module data connect is disclosed as hardware based,it will be appreciated that the hardware may be configurable by softwarein which case the hardware and software together may together form themodule data connect port of this disclosure.

The module processor 480 of the utility module can be any microprocessorcapable of accessing information stored in memory 485, performingactions based on instructions using information from memory 485 or someother source, and alternatively storing information in memory 485 ortransmitting information. An example of transmitting information can besending information from parameter module 460 to the defibrillator orthe external utility as discussed later in this disclosure. The moduleprocessor 480 may be configured to control the parameter module in anembodiment where a parameter module is included in the utility module.The module processor 480 may be configured to control the communicationmodule in an embodiment where a communication module is included in theutility module. The module processor 480 may also be configured tocontrol both the parameter module and the communication module anembodiment where both a parameter module and a communication module areincluded in the utility module. While FIG. 4 shows a module processor480 as a single processor, it will be appreciated that more than oneprocessor may also be used for module processor 480 in accordance withthis disclosure.

Memory 485 of the utility module can be any form of data storage. It maybe at least one of random access memory (RAM) and/or read only memory(ROM). Information can be stored permanently until overwritten and/orstored temporarily for use while the unit is active.

The power outlet 470 is illustratively configured to engage the powerconnect 445 of the defibrillator for providing an electrical charge 450to the defibrillator from the power source 465. Alternatively, the powerconnect 445 of the defibrillator may also provide power from the energystorage device 415 of the defibrillator to the power source 465 of theutility module when the utility module is without sufficient power tooperate as described later below. The power outlet 470 of the utilitymodule may illustratively be a hardware-based power connector configuredto connect with the power connect 445 of the defibrillator as describedbelow. Alternatively, the power outlet may be one or more powerconnectors that allow power to flow between the utility module and thedefibrillator. Illustratively, the power outlet 470 is a socketconnector configured for connection to the power connect 445 of thedefibrillator configured as a plug connector in a wired connection.Alternatively, the power outlet 470 may also be a plug connector and theplug connector of the power connect may be adapted to connect to theplug connector of the power outlet through a cable terminating on eitherend with a socket connector. As another example, each of the poweroutlet 470 and the power connect of the defibrillator may be socketconnectors that are adapted to be connected through a cable terminatingon either end with a plug connector. Other connectors may be used forpower outlet 470 as are well known in the art. While the power outlet isdisclosed as hardware based, it will be appreciated that the hardwaremay be configurable by software in which case the hardware and softwaremay together form the power outlet of this disclosure. When the poweroutlet 470 receives and engages the power connect 445, a power link 450is established for the bidirectional flow of power between the utilitymodule and the defibrillator.

Power source 455 can be can be a battery or fuel cell, a direct linefrom a wall outlet, current from a solar cell or any other power sourcesufficient to satisfy the power requirements for utility module 450.

FIG. 5 shows an illustrative embodiment of the utility module 455 ofFIG. 4. FIG. 5 shows the utility module 455 comprising the parametermodule 460; the communication module 490; the power outlet 470; the dataoutlet 475 configured to engage the data connect 440 of thedefibrillator 410 (shown in FIG. 4) for transmitting data to orreceiving data from the defibrillator 410; and a module processor 480configured to control the parameter module 460 and the communicationmodule 490. These components in FIG. 5 are the same components as areshown in FIG. 4 bearing the same number, and the description andoperation of these components in FIG. 5 are the same as the descriptionand operation of these components in FIG. 4.

In the illustrative embodiment, the module processor 480 controls theoperation of all the modules that make up the utility module.Alternatively, the utility module may be provided with more than oneprocessor for this purpose. As shown in FIG. 5, the module processor 480may illustratively be a processor and associated chipset (not shown)that advantageously enables interfaces such as the Serial (UART), SDIO,and USB to be used for connecting the utility module to othercomponents. For instance, the interfaces allow the processor to beconnected to the defibrillator 410, the parameter module 460 (a CO2module is shown in FIG. 5), a device agent (not shown but such asdescribed in FIG. 14 illustratively through a data outlet 475 shown inFIG. 5 as described in FIG. 4), a Wi-Fi module 593 and external deviceslike an adjunct medical device (not shown but as described in FIG. 14below illustratively through a utility connect 600 shown in FIG. 5). Themodule processor 480, which is also sometimes referred to as processormodule, also enables other digital I/O interfaces such as to control LEDstatus information on an indicator panel 520 and to power manager 550 ofthe utility module. Illustratively the module processor may be aCM-T3517 processor made by Compulab. Alternatively, any one or moreprocessors that provide the functions that are within the scope of thisdisclosure may be used.

In the illustrative embodiment shown in FIG. 5, the parameter module 460is a capnography module configured to detect CO2 of a patient. Thecapnography module measures the CO2, respiration rate and pulse rate ofthe patient. The patient breathes into a CO2 input 462 of thecapnography module 460 with exhaust port 461 providing the exhaust portfor this inhaled breath of air after analysis by the parameter module.The parameter module 460 digitizes the breath data of the patient andapplies a stream of the digitized data over an RS232 communication link463 for input to the module processor 480.

FIG. 6 is an enlarged view of the parameter module 460 which also showsmanaged control of power to the parameter module 460 using a high sideswitch 593. High side switch 590 and its operation is described ingreater detail in the description of the power manager 550 below.Generally speaking, high side switch 590 is controlled by the moduleprocessor 480 through a control signal applied by the module processor480 to signal line 598. When the control signal is true, the high sideswitch 590 is turned on. This allows 3.3 volts of power on signal line584 to be applied to signal line 594 and to the parameter module 460causing parameter module to power on. Control of the parameter module460 occurs through TX, RX, CTS, RTS signals that are applied by moduleprocessor 480 to RS232 communication link 463 using a serial UARTinterface. The RS232 communication link allows the module processor 480to control the bidirectional transmission of data from the parametermodule 460 throughout the utility module. Advantageously, this allowsthe utility module to make data from the parameter module available tothe defibrillator and to other external devices as described in greaterdetail later below. Illustratively, the parameter module is aMicromedi-CO2 capnography module manufactured by Oridion. Alternatively,any module for monitoring patient parameter data may be used with thisdisclosure.

As previously discussed in connection with FIG. 4, the communicationmodule 490 may illustratively comprise a wireless module 491 and amodule data connect port 492. In the illustrative embodiment shown inFIG. 5, the wireless module 491 is a Wi-Fi module 593. In addition, themodule data connect port 492 is shown in FIG. 5 illustrativelycomprising a USB circuit 601, and a USB connect 600. The USB circuit 601and USB connect 600 and the Wi-Fi module 593 in the communication module490 are illustratively configured to transmit data from the utilitymodule 455. Specifically, Wi-Fi module 593 includes a radio transmitterand receiver and associated circuitry (not shown) for receiving andtransmitting wireless data preferably according to the 802.11 Wi-Fiprotocol. Alternatively, Wi-Fi module 593 may be configured to transmitand receive data by non-standardized protocols. In an alternativeembodiment, another communication module may be used in place of theWi-Fi module 593 and configured to receive and transmit wireless dataaccording to other communication protocols, such as blue-tooth, CDMA,etc. Alternatively, the other wireless modules may be included withWi-Fi module 593 in wireless module 491 shown in FIG. 4. As shown inFIG. 5, Wi-Fi module 593 is provided with an antenna 595 for receivingand transmitting Wi-Fi signals. Wi-Fi module 593 is configured tooperate under the direction and control of module processor 480. Forthis purpose, Wi-Fi module 593 is connected to an SDIO port 591 ofmodule processor 480 to enable module processor 480 to control thebidirectional flow of data to and from the Wi-Fi module 593. Moduleprocessor 480 may also control the processing of signals received byWi-Fi module 593. The memory 485 (shown in FIG. 4) of the utility modulemay be used by the processor to perform the algorithms required for theWi-Fi signal processing. Alternatively, a dedicated digital signalprocessor and associated memory included in the Wi-Fi module may be usedto perform these algorithms to process the signals. In the latter case,the role of the module processor 480 may be to control the bidirectionalflow of the wireless data processed by the Wi-Fi module through theutility module. Illustratively, the Wi-Fi module may be a Wi-Fi moduleRS9110-N-11-03 made by Redpine Signals. Alternatively, any Wi-Fi modulethat provides the functions detailed in this disclosure may be used.

FIG. 7 is an enlarged view of the Wi-Fi Module 593 of FIG. 5 which alsoshows the control of power to the Wi-Fi Module 593 using a high sideswitch 597. High-side switch 597 and its operation are described ingreater detail in the description of the power manager 550 later below.Generally speaking, high side switch 597 is controlled by moduleprocessor 480 through a managed control signal applied by moduleprocessor 480 to signal line 599. When the control signal is true, thehigh side switch 597 is turned on. This allows 3.3 volts of power onsignal line 584 (illustratively the same signal line as in FIG. 6) to beapplied to signal line 596 and to the Wi-Fi Module 593; causing theWi-Fi module to power on. Control of the Wi-Fi module 593 occurs throughclock, data, and CMD signals that are applied by module processor 480 tothe Wi-Fi module 593. The SPI/SDIO signal lines 592 allows the moduleprocessor 480 to control the bidirectional transmission of data from theWi-Fi module 593 throughout the utility module. Advantageously, thisallows the utility module to import data from the Wi-Fi module which theutility module can make available to the defibrillator through datacommunication link 441 (see FIG. 4) and to other external devicesthrough the communication module 490. The utility module may use themodule data connect port 492 (See FIG. 4) of the utility module toexport data to the external devices. More particulars on thecommunication between the utility module and external devices aredescribed later below.

Referring again to FIG. 5, the Wi-Fi module 593 may also provideWi-Fi-Status information to a user by displaying Wi-Fi statusinformation on an indicator panel 520. The Wi-Fi status information maybe provided using a Wi-Fi status LED 521 comprising one or more LEDlights or banks of one or more LED lights. For instance, if only one LEDis used, the light may be configured to turn “on” when the Wi-Fi module593 is in an active mode of operation, “off” when the Wi-Fi module 593is in inactive mode of operation, and “flicker on-off” when the Wi-Fimodule 593 is transmitting or receiving data.

The USB circuit 601 of the communication module 490 is illustrativecircuitry well known in the art for processing a signal for transmissionover the USB connector 600. The USB connect 600 is configured totransmit data from the utility module 455 to an external utility such asadjunct medical device shown in FIG. 14 and described later below. TheUSB circuit 601 supports the USB connect 600.

An RS232 circuit 478 of the communication module is illustrativelycircuitry well known in the art for processing a signal for transmissionover data outlet 475, which as illustratively described in FIG. 4 isconfigured according to the RS232 protocol. In FIG. 5, the data outlet475 is illustratively configured to transmit data from the utilitymodule in serial format to the defibrillator 410 shown in FIG. 4. Asdiscussed below, this RS232 signal connector may be used for thebidirectional exchange of data between the utility module and thedefibrillator. In alternative embodiments, additional RS232 outlets maybe provided to allow for the bidirectional exchange of data between theutility module and devices external to the utility that are other thanthe defibrillator such as computers, servers, laptops, mobile computingdevices, or other computing devices, as illustrated, for example, inFIG. 14.

The foregoing disclosure illustrates one of the advantages of thecommunication module 490 of this disclosure. The communication module ofthis disclosure enables the disclosed utility module to communicatebidirectionally with the defibrillator and external devices directly. Inaddition, the communication module allows the utility module to serve asa proxy for each or both the defibrillator and other devices external tothe defibrillator; allowing the defibrillator and the other devicesexternal to the utility module to communicate bidirectionally with eachother through the utility module acting as proxy, with more details onthe particulars of this implementation provided in greater detail laterbelow. In other words, the disclosed utility module may be configured toserve as a proxy for the defibrillator by enabling the defibrillator tocommunicate through the utility module directly with an external device.Similarly, the disclosed utility module may be configured to serve as aproxy for devices external to the utility module by enabling theexternal devices to communicate through the utility module with thedefibrillator. As proxy to either or both defibrillator and otherdevices external to the utility module, the utility moduleadvantageously provides a gateway for a defibrillator and other devicesexternal to the utility module to contact and communicate with eachother. The ability of the utility module to both communicate directlywith the defibrillator and external devices and to serve as a gatewayfor enabling communications between the defibrillator and externaldevices provides a powerful tool for integrating external devices and adefibrillator into an integrated defibrillation system according to thisdisclosure. Through this integration, one or more external devices maybe brought into direct communication with a rescuer at the site of adefibrillation in order to observe and participate in the defibrillationprocess. This enables external devices to provide real-time coaching tothe user of a defibrillator during a defibrillator process. Theinclusion of a network of resources in the defibrillation processfurther enables a more holistic approach to be brought to thedefibrillation process as compared to conventional approaches which arelargely a private affair between the rescuer and the patient. In short,this disclosure advantageously makes possible the “virtual”participation of a network of resources in a defibrillation process.

Through this disclosure, external devices may also be educated withpatient and other data obtained during and in connection with thedefibrillation process which may be used in post-defibrillationprocedures, coaching education, historical studies, and for otherpurposes. In addition to virtual participation by remote resources, theability of the disclosed utility module to itself directly communicatewith the defibrillator enables “physical” participation by a second teamof rescuers using the utility module who are at the site of thedefibrillation process but not actually administering thedefibrillation. For example, where space constraints limit the number ofrescuers that may occupy the immediate vicinity of the defibrillator,the utility module enables additional rescuers to assist in thedefibrillation process from a contiguous or nearby vicinity in real-timesince the utility module is in seamless communication with thedefibrillator. In these and other configurations, the utility module 490is seen to enable enhanced coaching and enhanced functionality to bebrought to the defibrillator and/or the site of the defibrillation.These and other advantages are further elaborated upon and discussedbelow.

In the illustrative embodiment shown in FIG. 5, power source 465 shownin FIG. 4 is illustratively illustrated as the power manager 550. Thepower manager and included battery authentication and security schemesare described in detail later below.

Referring still to FIG. 5, utility module further comprises a fan 506and a fan controller IC 503. The fan controller IC 503 applies a signalto fan 506 based upon a control signal applied by the module processorto the fan controller IC 503. The fan controller IC 503 generates itsown fault or over temperature condition sensed by the fan controller ICfor use by the processor in controlling the fan. The fan controller IC503 is illustratively powered by a 5 volt signal from the power managermodule 550. The fan 506 advantageously provides utility module 455 withcirculating air to cool the components internal to the utility module455 and to cool a docked defibrillator as described later in thisdisclosure.

FIG. 8 shows an enlarged view of the fan controller IC. Fan controllerIC is illustrated in FIG. 8 as a temperature monitor to illustrate afeature of the fan controller IC 503 in controlling temperature. Theelectrical components inside the utility module generate heat and toomuch heat can lead to component failures. To prevent overheating, thetemperature monitor includes a temperature sensor (not shown) configuredto sense and monitor the temperature. The temperature monitor iscontrolled by module processor 480 (in FIG. 5) through a control signalapplied by module processor through the I2C port. The module processor480 communicates with the fan controller IC using an I2C protocol. Thefan controller IC senses an overheating condition and triggers fault andalert information to the processor when the fan controller IC 503detects an over-temperature condition or a failure of the SMBus. Theprocessor may respond to fault and alert triggers from the temperaturemonitor by corrective signaling to adjust the speed of the fan or byutility module system turn-off in the event of a catastrophicoverheating condition.

As previously discussed (FIG. 5), utility module 455 comprises anindicator panel 520. The indicator panel may comprise LED indicatorlights for Wi-Fi status LED 521, AC/Battery LED 523, NET status LED 525,and Wi-Fi signal strength LED 527. The Wi-Fi status LED 521 has beenpreviously described. The AC/Battery LED, NET status LED, and Wi-Fisignal strength LED are controlled by signals applied by the processor.For instance, the processor may signal the AC/Battery LED to turn “on”in order to indicate that there is an adequate charge on the battery andto turn “off” to indicate a need to recharge the battery. The NET statusLED feature is a network service external to the utility module whichmay use the utility module of this disclosure as a proxy to coach theuser of a defibrillator as indicated above and described in greaterdetail below. In connection with this feature, the processor may signalthe NET status LED to be “on” to indicate that the NET service isconnected or communicating with the utility module 455 and to be “off”to indicate a state in which the utility module is not connected orcommunicating with a NET service. The processor may also signal theWi-Fi signal strength LED to indicate the strength of the Wi-Fi signal.For instance, the processor may signal the Wi-Fi signal strength LEDlight to be “on” to indicate that the Wi-Fi signal strength is strong,to be “flickering” to indicate that Wi-Fi signal strength is marginal,and to be “off” to indicate low Wi-Fi signal strength.

It will be appreciated that additional indicator lights and/or banks ofindicator lights may be provided to the utility module of thisdisclosure to provide a user with more information. The additionalinformation provided by the additional lights may include information onsome other event, such as is whether a defibrillator is connected to theutility module or whether the defibrillator and the utility module areproperly connected or whether the defibrillator is ready to place acharge on a patient. Alternatively, the additional information may bedirected to more detailed information about any of the above or otherpieces of information. For instance, a series of LEDs may be provided onthe indicator panel 520 to provide more information about a single eventsuch as the level of charge in a battery. For instance, a series ofthree lights may be used whereby the processor may signal all threelights to be “on” when the power available to the utility module is in ahigh power availability state. The processor may signal two lights to be“on” when the available power has dropped to an intermediate level; andone light to be “on” to alert the user that the power available to theutility module is low and the utility module should be connected to anAC outlet to be recharged. As yet another example pertaining to power,the processor may signal lights on the indicator panel to display faultconditions with the power system of the utility module 455. The abilityto deliver effective and repeated charges from a defibrillator to apatient is fundamental to the successful use of the defibrillator andthis disclosure enhances that ability. The indicator panel features ofthis disclosure including the Wi-Fi and NET connection and poweravailability features provide important coaching information to a userof a defibrillator useful in improving the success of a defibrillation.

FIG. 9 shows an embodiment of the indicator panel 520 comprising a Wi-Fisignal strength gauge 527, a Wi-Fi manual ON/OFF switch 605, along withthree LEDs illustratively one each for Wi-Fi status LED, AC/Battery LED,and NET status LED described above. The FIG. 9 panel is illustrativeonly and the particular information displayed and the arrangement ofthat display is a matter of design choice. It will also be appreciatedthat while the lighting has been shown as an LED lighting arrangement,any light source may be used to display the information on the indicatorpanel 520

The Wi-Fi manual ON/Off switch 605 is useful for quickly disabling Wi-Fifunctionality where, for example, it is forbidden to use wirelesscommunication. For instance, Wi-Fi is generally prohibited in a numberof hospitals and in airplanes. If a patient undergoing defibrillation isbeing taken into a hospital or an airplane from an ambulance where, forexample, the Wi-Fi functionality of the disclosed utility module wasbeing used for coaching or for patient data downloads to an externaldevice according to this disclosure, the user may simply flip the Wi-Fiswitch off to prevent the utility module from interfering, for example,with hospital equipment, or with airplane avionics.

It will be appreciated from the discussion in FIGS. 4-9 above thatutility module 455 may help optimize the timing and manner of applying adefibrillator charge to a patient based upon data provided by theutility module to the defibrillator and data provided by thedefibrillator to the utility module. The data from the defibrillatormay, for example be patient vital data and the data coming from theutility module may, for example be data generated internally to theutility module, such as patient parameter data from the parameter module460 shown in FIG. 5. In addition as previously discussed, the data fromthe defibrillator may be passed by the utility module over to externaldevices and similarly the utility module may pass data from externaldevices to the defibrillator; in both cases with the utility moduleacting as a proxy to the source of the data. In either way, the utilitymodule can use internally generated data and/or data provided byexternal devices to advantageously provide external coaching, to theuser of the defibrillator to assist the rescuer to optimize thedefibrillation results, such as the VF correction.

The ability of the utility module to serve as a proxy to both externaldevices and the defibrillator thus advantageously expands the paradigmof coaching available to a defibrillator from coaching that hasconventionally been localized to coaching that may involve virtualresources that are connected to the defibrillator by a network throughthe disclosed utility module. As discussed in greater detail laterbelow, the networked connection of external devices to a defibrillatorthrough the utility module of this disclosure enables delivery of datafrom one or more external resources to the defibrillator; therebyenabling network participation in the defibrillation process such as byhospital monitoring of a patient or by coaching of the rescuer bytrained medical personnel remotely in order to provide for a moreeffective defibrillation process. The external resources that mayvirtually participate in the defibrillation process and afterwards mayillustratively be a medical director or an asset manager. These andother resources discussed below as well as users of the utility moduleare enabled by this disclosure to participate in the defibrillationprocess to provide a more holistic approach to the defibrillationprocess and a more effective defibrillation procedure.

To operate the defibrillator shown in FIG. 4, the defibrillator dataconnect port 440 and power connect 445 of defibrillator 410 areelectrically connected to the data outlet 475 and the power outlet 470,respectively, of the utility module 455. In particular, defibrillatordata connect port 440 of defibrillator 410 is received by data outlet475 of utility module 455 to provide the data communication link 441shown in FIG. 4 for the bidirectional transmission of data betweendefibrillator 410 and utility module 455. Similarly, power connect 445is received by the power outlet 470 to provide the power link 450 shownin FIG. 4 for the transmission of power between the utility module andthe defibrillator.

In operation, both the defibrillator and the utility module are firstpowered on. The power-on enables power to be transmitted from thedefibrillator to the utility module or from the utility module to thedefibrillator over the power link 450 as further described later below.Illustratively, the power source 465 of the utility module is providedwith an electrical cord with a plug connector. Typically, the plugconnector is connected to an AC outlet for providing AC power to theutility module from an AC power source when AC power is available. AnAC-to-DC converter (not shown) internal to the power manager 550 (inFIG. 5) converts the AC power to the DC power levels required to operatethe utility module as well as the DC power level that is applied to thepower outlet 470 of the utility module for use by a defibrillator whenconnected. When AC power is unavailable or inadequate, the power manager550 (see FIG. 5) is configured to switch the power that is used by theutility module and applied to the power outlet 470 of the utility moduleover from AC power to the power source 465 which provides DC power froma battery as described later below. The delivery of power within utilitymodule is managed by a battery manager IC shown in FIG. 28 and discussedlater below. In an alternative embodiment, if on power-up, there isneither adequate AC power available nor adequate charge in the DC sourcewithin the power source 465, then the defibrillator may be configured toprovide power to the utility module over power link 450. In thisexample, the power from the energy storage device 415 of thedefibrillator is used to power both the defibrillator and the utilitymodule; although this is not a preferred mode of operation. Moretypically, it is the other way around with the utility module providingthe power requirements for powering the defibrillator. In either case,the power manager 550 shown in FIG. 5 and described in FIG. 28 below ofthe utility module is configured to manage the power flowing between thetwo devices over power link 450 when both devices are powered on.

Hence, the utility module is seen to also provide defibrillators with areserve of power to enable defibrillators to extend the length andnumber of charges that may be delivered by the defibrillator. Thisenables defibrillators to be used where power is unavailable and toenable defibrillators to deliver multiple charges more readily anywhere,anytime.

Once both devices are powered on, the data communication link 441 shownin FIG. 4 is established; thereby allowing data from the defibrillatorand from the utility module to be transmitted to the other device overthe data communication link 441. Illustratively, the transmission occursin accordance with the RS232 protocol as previously discussed.Alternatively, the transmission of data over the data communication link441 may occur using the USB protocol or other protocol. Data may also betransmitted using non-standardized methods. Further, while the RS232protocol provides for the serial transmission of data, it will beappreciated that the data may be transmitted in parallel or otherformats. In addition, while the data connection link 441 has beendescribed as a wired connection, it will be appreciated that the dataconnection link 441 may also be a wireless data communication link.

Hence, at power-on, the defibrillator and the utility module in thedisclosed defibrillation system are seen to share both their data andpower resources with the other device which provides the user withadditional functionality for use in improving the defibrillationprocess. For example, the bidirectional flow of data and power madepossible by this disclosure allows the two devices to work together as ateam in a system enabling the user to provide a more effectivedefibrillation to a patient. With respect to shared data resources, thesystem allows the utility module to provide the user of thedefibrillator with coaching based on data generated by the utilitymodule, such as patient parameter data; as well as data generatedexternally to the utility module by network resources and that theutility module passes through to the defibrillator as a proxy of thenetwork resources as discussed herein. In addition, the system allowsthe defibrillator to provide the utility module and external deviceswith defibrillator data that enables the utility module and externalresources to tailor their coaching of the defibrillator to fit the dataas discussed in greater detail below. Moreover, the defibrillator dataprovides a valuable source of relevant data useful forpost-defibrillation treatment. The defibrillator data may also be usedfor coaching-improvement activities, data studies, or other purposes.

FIG. 10A shows an illustrative embodiment of an electrical circuitconfiguration 606 for the utility module 455 of FIG. 5 of thisdisclosure. The circuit configuration 606 comprises interface board 650,smart battery pack 640, antenna PCB 683, capnography module 460, andAC-to-DC converter module 670. The interface board 650 comprises amodule processor 480 illustrative including a first processor P1 and asecond processor P2, a Wi-Fi module 593, an RS232 circuit 478, a USBcircuit 601, a series of connector outlets and a series of connectors asshown in the figure. The connector outlets and connectors shown in theFIG. are used to connect the elements shown in FIG. 10 to formelectrical connections between the elements; such as connecting thesmart battery pack 640 including battery 641 to the interface board 650;connecting a data outlet 475 to the interface board 650; connecting theinterface board to a test system 679; connecting a utility connect 600which is configured to receive a USB connector (not shown); connectingantenna 683 with the interface board 650 ; connecting the capnographymodule 460 to the interface board 650; and connecting an AC-to-DCconverter module 670 to provide DC power to the interface board. Anelectric circuit printed on the interface board 650 provides theelectrical signal lines for electrically connecting these componentstogether into an illustrative utility module of this disclosure.

Advantageously, series connectors 652 and 772 are available for use inproviding connections to other modules that may be added to the utilitymodule to enable the utility module with more functionality. Forexample, the illustrative embodiment of FIG. 10A shows a utility moduleconfigured with a capnography module 460 which is used to measure theCO₂ exhaled by a patient. Series connectors 652 and 672 and otherconnectors may be used to configure the utility module for use withother parameter measuring modules as well; adding to the functionalityenabled by the capnography module. For example, these and other seriesconnectors may be used to configure the utility module with capnographymodule to also be used with a module that measures the electricalactivity of the heart of a patient. The series connectors may be used toconfigure the utility module for use with a module that measures thepressure of the blood in a patient using non-invasive blood pressuremeasurement techniques or invasive blood pressure measurementtechniques. The series connectors may be used to configure the utilitymodule for use with a module that measures the temperature of a patientusing temperature measurement techniques. The series connectors may beused to configure the utility module for use with a module that measuresan oxygen saturation in the blood of a patient using pulse oximetertechniques or tissue oximetry techniques. The series connectors may beused to configure the utility module for use with a module that measuresa chest compression of a patient using chest compression detection andfeedback techniques. The series connectors may be used to configure theutility module for use with a module that measures an image of theinternal structure of a patient using ultrasound measurement techniques.The series connectors may be used to configure the utility module foruse with a module that measures an oxygen saturation in the blood in thebrain of a patient using cerebral oximetry techniques. The seriesconnectors may be used to configure the utility module for use with amodule that measures the acidity or alkalinity of fluids in a patient ismeasured using non-invasive pH measurement techniques. Hence, connectorssuch as 652 and 672, as well as other wired or wireless ways ofconnecting a module to the interface board, provide a way for enablingthe utility module with more robust functionality.

The decision of whether or not to include one or more additional modulesinto a utility module may depend on the intended application of theutility module and also the cost. In some cases, a user may not want toinclude one or more additional modules at the time of purchase eitherbecause it is not needed or because doing so is cost-prohibitive.However, at some later point in time, the user may want one or moreadditional modules added to the purchased utility module to give it morefunctionality and/or robustness. As shown in FIG. 10B, this disclosureaddresses this problem by providing a utility module with a modulardesign 700 that may be readily scalable in performance by the inclusionof one or more parameter module cartridges 720, 722, or other modulesafter manufacture; making the disclosed utility module configurable forany application or budget. In this scalability feature of thisdisclosure, the utility module 455 is provided with one or morereceptacles 701, 711 for receipt of additional modules 720, 722 that maybe provided as cartridges. The receptacles 701, 711 are each providedwith an electrical connector 702, 712, which are in wired connectionwith electrical connectors 752, 772 of the interface board 750previously described in connection with FIG. 10A as well as power source465 of the utility module 455. The utility module cartridges 720, 722,are illustratively each likewise provided with electrical connectors703, 713 for mating engagement with electrical connectors 702, 713. FIG.10B shows one such mating engagement 714 formed between connectors 712and 713 of receptacle 711 and utility module cartridge 722 respectively.The mating engagement provides an electrical connection of the utilitymodule 722 both to the power source 465 and the data bus 705, 715. Thepower source provides the inserted utility module cartridges with powerfrom the utility module 455 to operate and the data bus 705, 715 providea data communication link between the inserted utility module cartridges720, 722 and the utility module 455; enabling the inserted utilitymodule to add its functionality to the functionality already provided byutility module 455.

Hence, the scalability feature of this disclosure described in FIG. 10Benables the utility module of FIG. 10A which is illustratively providedwith capnography functionality only to be boosted in functionality bythe inclusion into the utility module 455 of one or more additionalutility module cartridges 720, 722 each containing an additionalfunctionality. These utility module cartridges are illustrativelyparameter modules that measure parameters that are different from thosemeasured by a capnography module. For example, the inserted utilitymodule cartridge may include functionality that measures an electricalactivity of the heart of a patient; an exchange of air between the lungsof a patient and the atmosphere; a pressure of the blood in a patient; atemperature of a patient; an oxygen saturation in the blood of apatient; a chest compression of a patient; an image of the internalstructure of a patient; an oxygen saturation in the blood in the brainof a patient; or the acidity or alkalinity of fluids in a patient.Alternatively, one or more of the inserted utility module may include aplurality of the foregoing parameter modules to enable the capnographymodule illustrated in the FIG. 10A with even more functionality tomonitor a plurality of patient parameters.

In addition, the one or more inserted utility module cartridges need notbe modules that measure a patient parameter different from thecapnography module used in the FIG. 10A example; or whatever othermodule an original utility module may be purchased with. Indeed, theadditional module cartridges may also include one or more capnographymodules which provide the utility module 455 with multiple capnographymeasuring capabilities; thereby allowing the utility module 455 to beused with different patients contemporaneously. In this example, atleast one of the capnography modules may also be used for redundancypurposes, for use in the event one of the one or more other capnographymodules fails.

Moreover, it will be appreciated that module cartridges other thanparameter module cartridges may be used with this disclosure. Forexample, a utility module 455 that was purchased with a communicationmodule (FIG. 4) that provides Wi-Fi functionality could be boosted inperformance by inserting for utility module cartridge 720 shown in FIG.10B, a utility module cartridge that is provided with Blue Tooth or CDMAfunctionality, for example. It is hence seen that a set of two or moreutility module cartridges—each with its own one or more parameter orother modules connected to its own interface board in a manner similarto the way the capnography module is shown connected to the interfacemodule in FIG. 10 or in other ways may be connected together withutility module 455 to provide a more functional and robust bundledutility module (e.g., in this example, the utility module with modulardesign 700 together with one or more utility module cartridges likeutility module cartridges 720, 722 electrically connected thereto) foruse with a defibrillator. The bundled utility module enhances theeffectiveness of the coaching that may be provided to a rescuerperforming a defibrillation since the coaches that are making use of thebundled utility module, whether located at the site of the utilitymodule or remotely participating in the defibrillation process virtuallyover the network, have more patient data to work with as a result of themore functionality and/or robustness in one or more specificfunctionalities provided by the bundled utility module of thisdisclosure.

As an alternative to creating a bundled utility module using utilitymodule cartridges, this disclosure provides additional ways in which abundled utility module may be provided including arrangements involvingelectrically interconnecting two or more independent utility modules asdiscussed in connection with FIGS. 30 and 33 below. For example, FIG. 30illustrates the use of individual utility modules bundled together in avertical stacked arrangement. FIG. 33 illustrates how individual utilitymodules may be linked together in a daisy chain arrangement.

FIG. 11 shows one illustrative example of a display 775 of someinformation that may be displayed on a display 425 (FIG. 4) of thedefibrillator for the purpose of coaching the user on the use of thedefibrillator when connected to the utility module of FIG. 4 inaccordance with the disclosed system. Display 775 shows a display screen785 on defibrillator 410 (FIG. 4) which displays heart beat waveform 782along with heart rate information of 128 together with an SpO2 waveform783 along with SpO2 information of 100 and an iconic gauge 776 showingthe SpO2 level of the patient. Both the heart beat information and theSpO2 levels are generated by the defibrillator in this example.

As previously discussed, the utility module of this disclosureillustratively includes a parameter module that is illustratively a CO2parameter module. Referring now to FIG. 12, display 775 shows theadvantages provided by this feature of the disclosure in that the CO2information generated by the utility module is advantageously displayedon the display of the defibrillator shown in FIG. 12. The CO2information is illustratively displayed by way of mmHg information whichin this case is 37 mmHg. Hence, in FIG. 12, a utility module is seen toprovide the user of the defibrillator with coaching based on the CO2information of the patient which the user may advantageously use toimprove the success of the defibrillation.

In FIG. 13, display 775 shows further information that may be providedto the defibrillator by the utility module of this disclosure. Display775 shows a display screen 785on defibrillator 410 (FIG. 4) which inaddition to displaying the information in FIG. 12 is further displayingCO2 alarm limits in the form of the high and low range of CO2 789 in thebreath of a patient which is shown as 43 mmHg and 33 mmHG, respectively,on the defibrillator display . This FIG. 13 hence further illustratesthe advantageous feature of the disclosure in which a utility module isproviding the user of the defibrillator with coaching based on the CO2information of the patient which the user may advantageously use toimprove the success of the defibrillation. In another illustrativeembodiment, the CO2 signal itself may also be displayed on thedefibrillator display. In addition, each of the heart information andthe SpO2 information respectively shows the high and low alarm limitsfor each of the heart rate and the SpO2 rate. This range is typicallycalculated by the defibrillator processor but may be calculated in themodule processor.

Alternatively, the module processor of the utility module of thisdisclosure may be used to make these and other more complexcomputations; thereby freeing up the processor of the defibrillator toperform other tasks. For this purpose, the defibrillator may down-loadin real-time the heart and SpO2 data it generates to the utility moduleover the data communication link 441 (FIG. 4) that is establishedbetween the defibrillator and the utility module. The utility moduleprocessor may then perform the complex computations and return thecomputed data to the defibrillator for display on the defibrillatordisplay. In this way, the utility module may free up the processor ofthe defibrillator to perform other vital operations; therebyadvantageously serving the defibrillator with additional utility moduleresources to allow for a more effective defibrillation.

While the foregoing FIGS. 11-13 illustrate the display of CO2 datagenerated by the utility module on the display of the defibrillator forcoaching purposes, it will be appreciated that data from other patientparameter modules included in the utility module may also be displayedon the display of the defibrillator for coaching purposes For example,the utility module may coach the defibrillator with data in connectionwith an electrical activity of the heart of a patient; an exchange ofair between the lungs of a patient and the atmosphere; a pressure of theblood in a patient; a temperature of a patient; an oxygen saturation inthe blood of a patient; a chest compression of a patient; an image ofthe internal structure of a patient; an oxygen saturation in the bloodin the brain of a patient; and/or the acidity or alkalinity of fluids ina patient.

These data may be generated from parameter detection modules that:measure CO₂ exhaled by a patient; an electrical activity of the heart ofa patient; an exchange of air between the lungs of a patient and theatmosphere; a pressure of the blood in a patient; a temperature of apatient; an oxygen saturation in the blood of a patient; a chestcompression of a patient; an image of the internal structure of apatient; an oxygen saturation in the blood in the brain of a patient;and the acidity or alkalinity of fluids in a patient.

Further, there may be other data that the utility module may generateinternally or receive from external devices that the utility module maysend to the defibrillator and this data too may be displayed on thedisplay of a defibrillator. The display of data from the disclosedutility module (either generated internally or passed through fromexternal resources) illustrates the coaching advantages made possible bythis disclosure. Coaching information from external resources or theutility module is immediately available to a rescuer for use in thedefibrillation. The coaching information can be made immediatelyavailable by display on the defibrillator display as indicated in theprevious example. Alternatively, it may be made available in other ways,such as by triggering audible or visual data streams to assist in thedefibrillation process. For example, the disclosed utility module mayenable a live video or audio stream to be fed to the defibrillator inorder to provide live or delayed audio or video to coach the rescuerthrough a defibrillation process, whether it be for coaching relating tosetting or applying the charge to the patient, to the mechanics of CPRtechniques that may be used in the process, or to other aspects of adefibrillation. As another example, the utility module may pass videofeed from an external device through to the defibrillator for display onthe defibrillator display for the purpose of providing the user withfurther coaching information. The video feed from the external devicemay include a video stream generated by an external device such as alaryngoscope or an ultrasound wand. In another illustrative embodiment,the utility module may be provided with a display and the utility modulemay display the video feed from the external device on the display ofthe utility module again for the purpose of providing the user withfurther coaching information. In this embodiment, the display of theutility module may also be used to show patient or device data as anadjunct to the defibrillator display; thereby freeing up space on thedefibrillator's display. As yet another example, the disclosed utilitymodule may trigger audible or visual alerts on the defibrillator whenthe defibrillation process moves close to or outside an operatingenvelope that has been defined for operation of the defibrillator.

In addition, the disclosed utility module enables the control of thedefibrillator remotely whereby a remote resource may partly orcompletely take over control of the defibrillator functionality thatdetermines the defibrillation operation such as settings, such as thecharge level to be applied to a patient. This feature enables trainedmedical personnel to determine and set the proper operation, settings,etc. of the defibrillator in circumstances where the rescuer at thescene may be without the medical training to make these determinations;thereby increasing the likelihood of success of the defibrillation. As aresult, defibrillator-monitors—which are intended to be used by personsin the medical profession, such as doctors, nurses, paramedics,emergency medical technicians, etc. who may be trained to providemedical treatment to the patient during a defibrillation process basedupon information provided by the monitor—that are used with thedisclosed utility module may be deployed more widely. No longer is itnecessary to generally limit access to such a defibrillator-monitor totrained medical professionals. With the disclosed defibrillation system,the defibrillator-monitor may be used more widely in the field. In anormal mode of operation, these defibrillator-monitors that may bewidely deployed may come with the functionality requiring trainedmedical expertise to operate disabled so as to allow the defibrillatorpart of the device to be used broadly by members of the public providedthey have obtained first aid and CPR/AED training, much like the broaddeployment conventionally seen with an AED. In a second mode ofoperation, such as a monitoring mode of operation, the monitoringfunctionality of the defibrillator-monitor that is used with thedisclosed utility module may be enabled. In one embodiment, theenablement occurs by remote resources that can take over and use thisfunctionality remotely. In another embodiment, the enablement may occurby a doctor or other medically trained personnel who happen to be at thesite where the defibrillation is needed. In these instances, themonitoring functionality may be enabled by the trained medical personnelsuch as by entry of a password into a keyboard that may be provided onthe defibrillator-monitor. In another example, the functionality may beenabled remotely after a network resource has validated the identity ofthe medical provider qualified to use the monitoring functionality. Ineither and other cases, the disclosed system enables more pervasive useof defibrillator-monitors in the field because of the controls on theuse of the monitoring features that are provided by this disclosure.

In the above and other ways, a utility module configured with one ormore of these parameter modules, or a set of utility modules with one ormore of these parameter modules and bundled together in a stack or otherarrangement, when used together with a defibrillator, form adefibrillator system that allows for a wide range of information to bemade available to the user of the defibrillator to aid in thedefibrillation process. The foregoing and other coaching provided by theutility module in the defibrillator system of this disclosure thus helpsa user of a defibrillator to optimize the timing and manner of applyinga defibrillator charge to a patient based upon these parametricconditions. The foregoing and other coaching provided by the utilitymodule in the defibrillator system of this disclosure helps assist therescuer optimize the timing and manner of applying a defibrillatorcharge to a patient. The utility module in the defibrillator system ofthis disclosure enables external devices to better coach users of thedefibrillator through data transmitted to the defibrillator through theutility module as a proxy for the external devices as described ingreater detail below. The utility module of this disclosure may alsoreceive data from the defibrillator during or before or afterdefibrillation for use by the utility module or for transmission by theutility module as proxy to the defibrillator to external devices also asdescribed in greater detail below. The utility module in thedefibrillator system of this disclosure also helps providedefibrillators with a seamless communication link for the communicationof data between the defibrillator and the one or more external devices.The utility module in the defibrillator system of this disclosure alsohelps provide defibrillators with a seamless integration with one ormore external devices into a system that can provide a more holisticapproach to the defibrillation process and a more effectivedefibrillation process.

FIG. 14 shows an illustrative embodiment of a defibrillator system 800comprising the defibrillator system 400 of FIG. 4 and a network 870. Thedefibrillator system 400 comprises defibrillator 410 and utility module455 of FIG. 4. The defibrillator 410 components of defibrillator port420, energy storage device 415, defibrillator processor 435, memory 430,defibrillator data connect port 440, and power connect 445; as well asthe utility module 445 components of a module processor 480, a memory485, a communication module 490, a parameter module 460, a power source465, and a power outlet 470 are the same in description and operation aslike number components in FIG. 4. The utility module components ofutility connect 600, USB circuit 601, RS232 circuit 478, Wi-Fi module593, module data connect port 492 are the same in description andoperation as like number components in FIG. 5 The network 870 comprisesa server 810, and a utility application 820 (e.g., a device agent orother application) on a computer (e.g., laptop or PC). While the deviceagent on computer is shown in this illustrative figure to resideexternally to the utility module, it will be appreciated that the deviceagent may be configured to reside on the utility module. The network 870may additionally or alternatively comprise an adjunct medical device 850and/or other existing applications on a computer.

Server 810 may be any computer configured to serve the requests ofclient programs running on the same or other computers on a network. Thecomputer configured to serve the requests of client programs is known asthe host computer. The programs running on the same or other computerthat are served by the host computer are known as clients. The clientsprovide the graphical user interface and perform some or all of theprocessing requests it makes from the server which maintains the dataand processes the requests. Depending on the computing service thatserver 810 is configured to offer, server 810 may include one or more ofa file server for storing and making files accessible for reading andwriting to the client, a print server that manages one or more printers,a network server that manages network traffic, a mail server thatmanages mail on a network, a database server that allows clients tointeract with a database, and/or a hospital server for managing hospitalrecords. Server 810 may also be in communication with one or more otherservers that themselves may include one or more of the foregoing orother servers.

Utility applications 820 may be a device agent or other application. Thedevice agent is a client software program that is configured to act forutility module 455 as an agent. Hence, the utility module 455 may serveas the host for the device agent in this example. FIG. 14 shows deviceagent illustratively residing on a laptop or personal computer externalto the utility module. The external computing device may be a personalcomputer, a laptop computer, a tablet, a mobile computing device, or aserver. Alternatively, device agent may reside in the memory unit 485 ofthe utility module itself. The adjunct medical device 850 is aprogrammed computer that provides tools for monitoring the technique ofa rescuer during the defibrillation process, such as applying CPR orproper positioning of the electrodes for application of a defibrillationcharge on the patient. Illustratively, the device may monitor CPR chestcompressions provided before or after defibrillation shock. For example,the device may measure the depth of a CPR chest compression, compare itto what it should be, and provide feedback to the user by way ofinstructions to go faster, deeper, etc. Alternatively, the adjunctmedical device may be any other device that monitors defibrillationtechniques and provides feedback to a rescuer at the site of thedefibrillation.

Utility applications 820 may also include existing applications that maybe one or more software applications running on one or more computingdevice external to the utility module for performing a dedicatedfunction. Examples of such functions include: performing specificservices or tests. The external computing device may be a personalcomputer, a laptop computer, a tablet, a mobile computing device, or aserver.

As previously described in connection with FIG. 4, the defibrillatordata connect port 440 and power connect 445 of defibrillator 410 arereceived by the data outlet 475 and power outlet 470 of the utilitymodule which each function and operate in the manner previouslydescribed in connection with the like numbered components described inconnection with FIG. 4. In FIG. 14, communication module 490 includesthe USB connect 600 with associated USB circuit (not shown), the Wi-Fimodule 593, an RS232 circuit 478 interfacing with data outlet 475 whichall function and operate in the manner previously described inconnection with the like numbered components described in connectionwith FIG. 5. Communication module 490 in FIG. 14 further includes anRS232 interface 801 which functions and operates in a like mannerpreviously described in connection with RS232 circuit 478 and dataoutlet 475 in connection with FIG. 5.

As shown in FIG. 14, power 450 from power outlet 470 is received bypower connect 445 for use by defibrillator 410. In addition,bidirectional data over data communication link 441 passes betweenutility module and the defibrillator through data outlet 475 anddefibrillator data connect port 440. In the defibrillator system 400 ofFIG. 4, it was described how the defibrillator system 400 advantageouslyallows for the flow of bidirectional data between the utility module andthe defibrillator. This data may include CO2 and capnography datatransmitted from parameter module 460 of the utility module to thedefibrillator as described in FIG. 5. As FIG. 14 further illustrates,this flow of bidirectional data advantageously enabled by thedefibrillator system 400 (FIG. 4) may also flow from the defibrillatorto the utility module and include patient episode data and device selftest status.

The system 800 shown in FIG. 14 expands the coaching capabilities of theFIG. 4 defibrillator system by including the network in the system andenabling several communication links for providing bidirectional flowsof data between the utility module, the defibrillator, and externaldevices in the network. For example, the system advantageously providesfor the bidirectional flow of data between the utility module and thedefibrillator as previously described. For example, the utility modulemay provide the defibrillator with CO2 or other physiological data froma parameter module and receive vital patient data from thedefibrillator. The memory of the utility module may also provideadditional memory capability to the defibrillator by storing patientdata that is unable to be stored in the defibrillator's memory becausethe defibrillator memory is full; thereby providing memory back-up andredundancy to the defibrillator for supporting the defibrillationprocess and user coaching. Further, the system advantageously providesdata communication links 441, 803, 805, 807 for the bidirectional flowof data between the defibrillator and one or more external devicesthrough the utility module acting as proxy for whichever device (e.g.,the defibrillator or the external device) is the source of the data. Forexample, the utility module may transmit the patient episode datareceived by the utility module from the defibrillator over to the server810 of the network by way of data communication link 803. This patientepisode data from the utility module to the server may be reformatted bythe utility module or simply passed through the utility device in theformat in which the defibrillator has put that data. In the former case,the utility module additionally provides a formatting functionality tothe patient episode data. In the latter case, the utility module servesas a conduit for the transfer of the patient episode data received fromthe defibrillator directly over to the server 810.

In addition, the utility module may also transmit and receive datatransmitted between the utility applications 820 and the defibrillatorover communication link 807. For example, device agent may update thesoftware and software configuration settings on the defibrillator byproviding the utility module with update device software/setup data forpass-through to the defibrillator. Data flow in the other direction mayinclude the utility module passing through to the utility applications820 enrollment information provided by the defibrillator.

In addition, the system advantageously provides for the bidirectionalflow of data generated by the utility module between the utility moduleand one or more external devices. For instance, the CO2 and capnographydata generated by the parameter module 460 of the utility module may betransmitted by the utility module over to the server 810 of the network970 over communication link 803 according to this disclosure. Theutility module may also transmit other data to the server 810 such asdata from an adjunct medical device, utility module status data, anddevice self status data. The utility module may also transmit andreceive data from the device agent. For example, device agent may updatethe software and software configuration settings on the utility moduleand/or the defibrillator by providing the utility module with updatedevice software/setup data for use by the utility module or for theutility module to pass on through to the defibrillator. The device agentmay also provide the utility module with a listing of preferred networksfor the Wi-Fi module of the utility module to use when connectingwirelessly within the network. Data flow in the other direction mayinclude the utility module providing the device agent with enrollmentinformation on the utility module and/or the defibrillator. The utilitymodule may also provide the device agent with a list of availablenetworks detected by the Wi-Fi module 593 of the utility module for theagent to use in compiling the list of preferred networks that the deviceagent may send to the utility module instructing the utility modulewhich network to use.

The utility module may also transmit and receive data from adjunctmedical device 850 over communication link 801 as shown in FIG. 14. Inthis illustrative embodiment, the adjunct medical data is transmitted tothe utility module through the utility connect 600, which isillustratively a USB connector in this example.

The utility module may also transmit and receive data from otherapplications over a communication link, which may be one of the wired orwireless communication links illustrated in FIG. 14 or other wired orwireless communication link established by the utility module. Inaddition, the system advantageously provides for the bidirectional flowof data between the one or more external devices and one or more otherexternal devices with the utility module acting as a proxy for thesource of the data. For example, information from the adjunct medicaldevice may be passed over to the utility module through communicationlink 801; through the utility module; and then passed over to the server810 through communication link 803.

In addition, the system advantageously provides for the bidirectionalflow of data between a plurality of defibrillator devices and theutility module. As shown in FIG. 15, in an illustrative defibrillatorsystem 880, a plurality of defibrillators 881, 882, 883, may beelectrically connected to a utility module 455 to provide the datacommunication links 890, 892, 894 of defibrillators 881, 882, 883,respectively, as well as the power links 891, 893, 895 of defibrillators881, 882, 883, respectively, in order to enable the utility module tocoach a plurality of devices contemporaneously.

Hence this disclosure enables bidirectional communication between theutility module and the defibrillator device; between the defibrillatorand one or more of the server 810, the utility applications (e.g.,device agent or other applications) , and the adjunct medical device,and/or other external devices and/or programs; between the utilitymodule and one or more of the server 810, the utility applications(e.g., device agent or other applications), the adjunct medical device850, and/or other external devices and/or programs; between externaldevices and other external devices through the utility module acting asa proxy for the device that is the source of the data; and a pluralityof defibrillator devices and the utility module.

In addition, the defibrillator system 800 shown in FIG. 14 expands thecoaching capabilities of the FIG. 4, 5 defibrillator system 400 evenfurther by advantageously enabling one or more devices external to theutility module that are part of the network 870 to communicate betweenthemselves for the purpose of educating the network so that moreinformed support may be brought to the user of the defibrillator throughthe utility module. For example, as shown in FIG. 14, the server 810 maybe configured for bidirectional communication with the device agent 820over data communication link 805. As one example, the server maycommunicate device and utility module software setup information to thedevice agent which the device agent may then download to the utilitymodule for configuring the settings and downloading software to theutility module or the defibrillator. As another example, the deviceagent may communicate device and utility module enrollment informationto the server 810 which the server may then use to determine whichsoftware to download to the device agent.

FIG. 16 shows an illustrative range of services 960 that the network mayprovide the utility module in supporting the user of the defibrillator.FIG. 16 shows defibrillator data connect port 440 of defibrillator 410received by data outlet 475 of utility module to enable bidirectionaldata communication between the defibrillator and the utility module overdata communication link 441 as discussed in FIGS. 4 and 5. Power connect445 of the defibrillator is also received by power outlet 470 of theutility module to allow power 450 to be made available from the utilitymodule for powering the defibrillator or for other shared power purposesas also discussed in FIGS. 4 and 5. FIG. 16 further shows utilityconnect 600, which is a USB connector in this illustrative embodiment,connected with a display 970, a video device 968, an ultrasound device966, a printer 964, and partner devices 962. Each of display 970, videodevice 468, ultrasound 960, printer 964, and partner devices 962 providean additional service to the utility module. For example, the videodevice 968 enables a user of the defibrillator to take photos or videostreams of data of the patient throughout the defibrillation process sothat the condition of the patient may be recorded throughoutdefibrillation for use in connection with the defibrillation or for somepost-defibrillation purpose, such as for use by medical professionals inproviding post-defibrillation treatment or for use by coaches on thenetwork in providing more effective coaching services going forward.

As another example, the ultrasound 966 enables the user to takeultrasound measurements of a patient during the defibrillation processto provide imaging information of the internal structure of a patientduring defibrillation or for use in post-defibrillation medicaltreatment or coaching applications. The display 970 may allow a monitor,for instance, to be connected to the utility module to allow for abroader or easier viewing of information that is either being displayedon the display of the defibrillator; is being generated by the utilitymodule and not displayed on the defibrillator display; is generated by adevice external to the utility module that is part of the networksupporting the utility module and is providing coaching to the user ofthe defibrillator; or other information. The display 970 may provide asupplemental display to the display that may be available on thedefibrillator and/or utility module or display 970 may provide the onlydisplay available to the user of the utility module and/or thedefibrillator. The display 970 may allow more people to view thedefibrillation process. It may also allow people who are using thedefibrillator and/or the utility module to view a larger screen than maybe available on the utility module or defibrillator

As illustrated in FIG. 16, the display 970, video device 968, ultrasound966, printer 964, and partner devices 962 are connected to the utilitymodule to provide bidirectional data communication over datacommunication link 921 via utility connect 600, which is illustrativelya USB connector port in this illustrative example. It will beappreciated that these functions could also be provided to the utilitymodule through any other wired connection or through a wirelessconnection according to this disclosure. The foregoing list of devicesthat may be connected with the utility module are illustrative only. Itwill be appreciated that any other device may be tethered to the utilitymodule to provide the utility module with additional functionality foruse by the user of the defibrillator during a defibrillation procedure

FIG. 16 further shows further functionality that the network may providethe utility module in supporting the user of the defibrillator in thiscase through Wi-Fi module 593. It will be appreciated that thesefunctions could also be provided to the utility module through a wiredconnection. As illustrated in FIG. 16, the Wi-Fi module 593 enableswireless communication over data communication link 923 between theutility module and a computer 908, a Net server 910, a tablet 974, ateam display 974, and an access point 976. The server 910 has beenpreviously described in connection with FIG. 14 which description isapplicable to the use of the server in the illustrative embodiment ofFIG. 16. The tablet is an example of a mobile computing device in theform of a tablet that may wirelessly communicate with the utility modulevia Wi-Fi module 593 of the utility module. Alternatively, any mobilecomputing device may be used in place of or in addition to the tablet,including a laptop computer, a smart phone, or any mobile computingdevice. These mobile computing devices may allow medical professionalsand others to communicate with the utility module and with each other asa part of the network in providing assisted coaching to the user of thedefibrillator through the utility module of this disclosure. Teamdisplay 994 may be a monitor or a flat screen TV; and is illustrativelya large flat screen TV that allows groups of professionals to observedata provided by the utility module or by another network device for thepurpose of coaching the user of the defibrillator through the utilitymodule of this disclosure.

The wired and wireless bidirectional data communication links betweenutility module and the network illustratively such as made possible bydata communication link 921 and data communication link 923 may furtherbe used to provide data from the defibrillator and/or the utility moduleto the network as previously discussed. For example, the parametermodule 460 configured to detect a parameter of a patient as previouslydescribed in connection with FIG. 4 may transmit patient data byhardwire, such as over the data communication link 921, or wirelessly tothe display 970 or other local secondary display. Similarly, this datamay be transmitted wirelessly, such as over data communication link 923,or by hardwire to team display 974 or another local secondary display.In addition, this data may be transmitted wirelessly, such as over datacommunication link 923, or by hardwire through access point 976 to aremotely located display. Hence, data from the utility module and/ordefibrillator may be pushed out to local or remote resources for use inproviding coaching feedback, education, or other purposes.

In the previous examples of devices that are in communication with theWi-Fi module 593, the communication may be a local area networkcommunication connection such as including well known point-to-pointcommunication methodologies and standards. The access point 976 shown inFIG. 16 illustrates a way of even further broadening the reach of thenetwork that is supporting the utility module in coaching a user of thedefibrillator. Communications between the Wi-Fi module 593 and theaccess point 976 may be over a communication link 925 in accordance withthe 802.11 standards or may occur by other wireless methods that allowfor the network supporting the defibrillator and utility module of thisdisclosure to broaden out even further to include public networks andother private networks. In effect, the access point 976 enables theutility module to reach through cloud 980 for the purpose of accessingany remote utility 990 in any public or private network that may beuseful to the utility module in providing coaching to the user of thedefibrillator. This feature arms the disclosed utility module with evenmore network resources for providing even more effective coaching of theuser of the defibrillator. The foregoing communications may occurcontemporaneously during a defibrillation process or may occur after thedefibrillation for the purpose of post-defibrillation medical treatmentor use in teaching the network how to provide more effective coaching inthe future, or for asset management purposes.

FIG. 17 illustrates the defibrillator system of FIG. 4 but configured tocreate a bidirectional communication link 993 with each of a server 810and utility application (computer) 994. The defibrillator 410 componentsof defibrillator port 420, energy storage device 415, defibrillatorprocessor 435, memory 430, defibrillator data connect port 440, andpower connect 445; as well as the utility module 445 components of amodule processor 480, a memory 485, a communication module 490, aparameter module 460, a power source 465, and a power outlet 470 are thesame in description and operation as like number components in FIG. 4.The utility module components of Wi-Fi module 491 and module dataconnect port 492 are the same in description and operation as likenumbered components in FIG. 5 The server 810 is the same in operationand description as like numbered component in FIG. 14. Utilityapplication (computer) 994 is an application on a computer that isconfigured to schedule the triggering of downloading data, such aspatient data, from the defibrillator using the utility monitor as aproxy and is described in detail later below. Each of the server 810 andthe utility application (computer) 994 includes a communication module991 and 992, respectively, which are identical in description andfunction to the communication module 490 of FIG. 4 and which providesone terminal end for the data communication link 993, the other end ofthe data communication link 493 formed by the communication module 490of the utility module. In FIG. 14, the server 810 is shown connected tothe utility module wireles sly whereas the device agent 820 is showncommunicating with the utility module by wired connection. FIG. 17illustrates that the server and another computer with a utilityapplication (computer) 994 in the example, may be connected wirelesslyor by wired connection. The operation of the server and eventagent/appln computer are discussed further later below.

FIG. 18 illustrates the defibrillator system of FIG. 4 but configured tocreate a bidirectional data communication link 1000 between the utilitymodule 455(configured to operate as a host utility module in this case)and a client utility module 995 and a bidirectional data communicationlink 996 between the client utility module and an external utility 997.The defibrillator 410 components of defibrillator port 420, energystorage device 415, defibrillator processor 435, memory 430,defibrillator data connect port 440, and power connect 445; as well asthe utility module 445 components of a module processor 480, a memory485, a communication module 490, a parameter module 460, a power source465, and a power outlet 470 are the same in description and operation aslike number components in FIG. 4. The utility module components of Wi-Fimodule 491, module data connect port 492, utility connect 600(configured as a USB in this case), is the same in description andoperation as like utility connect 600 in FIG. 5. RS232 connect 1001 is adata outlet configured to operate according to the RS232 standard.Client utility module is a program on a computer that is configured toact as a client for the utility module 455. External utility 997 is aprogram on a computer that is configured to provide some utilityfunction to the host utility module or the client utility module. Eachof the client utility module 995 and the external utility 997illustratively includes a communication module 998 and 999,respectively, which are identical in description and function to thecommunication module 490 of FIG. 4 and which provides one terminal endfor the data communication links, the other end of the datacommunication links being provided by a data communication link found inthe device to which it is connected. The foregoing further demonstratesthe ease with which the utility module may be connected to externaldevices through direct or indirect data communication links in order tofacilitate the coaching by the network of a user of the defibrillator.It will be appreciated that each of the client utility module 995 and/orthe external utility 997 may be configured to be connected to each otherin other ways including through a direct power link provided betweenthese or other external devices and the utility module.

In FIG. 18, the client utility module 995 is denoted as the “client” andthe utility module 455 as the “host” since the client is performingcalculations for use by the host in this example.

FIG. 19 illustrates a defibrillator system 1010 comprising the usedefibrillator system 400 of utility module 455 defibrillator 410 of FIG.5 and a network 1014 comprising a netserver 910 (in like description andoperation as net server 910 in FIG. 16) and a net client 1016 forcoaching a user of the defibrillator. In FIG. 19, the utility module isin data communication with the defibrillator over data communicationlink 441 and in power communication with the defibrillator over powerlink 450 in a manner previously described. In this example, the servernet 910 and net client are in a private network 1014 and the utilitymodule 455 is outside that private network. FIG. 19 shows that theutility module 455 may establish communication with server 910 andclient 1016 by going through cloud 980 (in like description andoperation as cloud 980 in FIG. 16). In this example, the private network1014 is provided with a gateway 1012 to the cloud 980. The gatewayprovides a public portal to the private network that is physicallyaddressable and hence reachable from the public network. In thisexample, the utility module reaches the server 910 by addressing thegateway 1012 to the private network 1014. The utility module may reachthe gateway through a Wi-Fi access port such as shown in FIG. 16.Alternatively, the utility module may reach the gateway using WAN orusing other communication technologies. The gateway may validate theutility module and then switch the data communication link 1011 that hasbeen established between the gateway and the utility module over to theserver 910 which is connected to the client 1016. This enables theclient to communicate with the utility module and the defibrillator inorder to provide more robust coaching to the user of the defibrillator.

The network 1014 may support transmission of relevant patient data fromthe defibrillator 410 in the field to emergency departments, cardiaccatherization labs, and other cardiac care locations to enable promptand optimal diagnosis and treatment or appropriate post-review of thedata by qualified medical personal. The network 1014 also enablesorganizations to manage their material assets and provides tools forremote physician consultation through the use of network consultingapplication.

Network 1014 may also provide event patient reports and data. Any reportor data transaction that occurs during a patient monitoring or therapyevent may be transmitted by the utility module 455 to the net server910. The patient event data may assist qualified medical personnel inmaking accurate diagnosis, disposition, and therapy decisions. Eventpatient reports created by a defibrillator may be transferred throughutility module 455 to the net server 910. The netserver 910 may be in aprivate network or a public network. If the net server 910 is in apublic network, the net PC gateway 1012 may be used for the utilitymodule to reach the network in which net server 910 resides aspreviously described. Through the net PC gateway, the utility module mayestablish bidirectional data communication with the net server for thepurpose of transmitting patient event data from the defibrillator to thenet server from which third party monitoring devices may retrieve thedata and communicate with the defibrillator for the purpose of coachingthe user of the defibrillator.

The net server may also enable reports to be generated from the datataken from the patient event and transmitted as needed after the event.This information may be useful in post-event analysis to supportpost-event medical treatment. For example, non-real-time data transfersof ePCR reports may be used in post-event analysis to document thetreatment, patient state, and diagnosis provided by pre-hospital careproviders. This information may also be useful as data for use inpost-event training of medical professionals in order to train medicalprofessionals to provide better coaching in connection with futureevents.

FIG. 20 shows an illustrative data communication system 1020 of thisdisclosure comprising a data interface 1030 for communication betweenthe utility module 455 and the defibrillator 410 and a serial interface1050 for communication between the utility module 455 and externaldevices (not shown). The defibrillator 410 components of defibrillatorport 420, energy storage device 415, defibrillator processor 435, memory430, and a defibrillator data connect port 440; as well as the utilitymodule 445 components of a module processor 480, a memory 4485, acommunication module 490, a parameter module 460, and a power source465, are the same in description and operation as like number componentsin FIG. 4. As shown in FIG. 20, the bidirectional flow of data betweenthe defibrillator 410 and the utility module 455 occurs across interface1030 and includes test interface commands, patient episode data, deviceself test status, CO2 waveform, vital signs, device status, datatransfer status, and vital signs. Interface 1030 is the hardware andsoftware architecture that enables the bidirectional data flow, asdescribed in FIG. 4, across the data communication link 441 between thedefibrillator and the utility module through the data outlet 475 of theutility module and the defibrillator data connect port 440 of thedefibrillator. Before describing more about the bidirectional data flowof data and the illustrative data and commands that may be included inthat data flow, it is important to describe the illustrativearchitecture that may make up interface 1030.

FIG. 21 shows a standard OSI module that may be used as described belowto provide interface 1010 of this disclosure. The illustrativearchitecture is portrayed using the 7-layer open systems interconnection(OSI) model. The OSI model defines a networking framework forimplementing protocols in seven layers and is well known in the art.Control is passed from one layer to the next, starting at theapplication layer in one station, and proceeding to the bottom layer,over the channel to the next station and back up the hierarchy.

As shown in FIG. 21, interface 1010 (FIG. 20) illustratively comprises aphysical layer, a data link layer, a network layer, a transport layer,and an application layer. Alternatively, the interface 1110 may furtherinclude a session layer and a presentation layer although these layersare not included in the illustrative embodiment.

Illustratively, the Physical Layer 1 of interface 1010 (FIG. 20) isillustratively an RS-X hardware defined by data outlet 475 (FIG. 4)which receives the defibrillator data connect port 440 (FIG. 4) of thedefibrillator 410 to complete the hardware connection between thedefibrillator and the utility module. The RS-X hardware conveys the bitstream between the defibrillator and the utility module through thenetwork at the electrical and mechanical level in accordance with theRS232 protocol. Illustratively, the bit stream is an electrical bitstream. Alternatively, a bit stream of light, radio signals, or otherdata streams may be used with this disclosure. Hence, in the disclosureof FIG. 21, the RS-X hardware provides the means for sending andreceiving data by electrical signals between the utility module and thedefibrillator, with the data outlet 475 and defibrillator data connectport 440 defining the cables, cards and physical aspects of thatphysical layer connection. While interface is illustratively RS-Xhardware, it will be appreciated that ISTN, ADSL, ATM, FDDI, CAT 1-5,coaxial cables, and other protocols with physical layer components maybe used to provide the bidirectional data flow in the interface enablingthe data communication link 441 of this disclosure.

Referring again to FIG. 21, illustratively, Data Link Layer (2), isillustratively an SLIP PPP protocol for encoding and decoding the datapackets into bits as described by the Point-to-Point Protocol (“PPP”)known as RFC 1661 as extended by RFC 1570 (PPP LCP Extensions).Alternatively, the data link layer 2 may include RFC 1661 updates suchas RFC 2153 (vendor specific packets) and RFC 5342 (IANA considerationsand IETF protocol usage for IEEE 802 parameters). The PPP 1162 protocolfurnishes transmission protocol knowledge and management and handleserrors in the physical layer, flow control and frame synchronization.The data link layer is divided into two sub layers: The Media AccessControl (MAC) layer (not shown) and the Logical Link Control (LLC) layer(not shown). The MAC sub layer controls how the defibrillator and theutility module in the defibrillator system of this disclosure gainsaccess to the data and permission to transmit it. The LLC layer controlsframe synchronization, flow control and error checking.

Referring to FIG. 22, the PPP Protocol 1200 of the Data Link Layer willmore specifically illustratively include a Link Control Protocol (LCP)and a network control protocol (NCP). The PPP LCP is configured forsetting up, maintaining, and terminating the link between devices suchas the defibrillator and the utility module and between the utilitymodule and an external device when the utility module is acting as proxyfor the external device in connection with communications between theexternal device and the defibrillator. The LCP may be configured withone or more of the following or other options: maximum receive typeoption; authentication protocol option; quality protocol option; magicnumber option; protocol field compression option;address-and-control-field compression option; and FCS alternativesoption.

The Maximum-Receive-Unit is illustratively set to allow for extension ofthe use of the utility module with a wide number of devices. TheAuthentication-Protocol (type 3) is illustratively an authenticationused to prevent unauthorized connections to the defibrillator and theutility module. Illustratively, the authentication protocol is based onRFC 1661. RFC 1661 identifies two protocols (PAP (RFC 1334) and CHAP(RFC)) for providing authentication of a connecting device. PAP is asimple request/reply authentication protocol. The PAP provides verylittle protection against many security risks, but may be sufficient forthe connection between the defibrillator and the utility module and soillustratively is used. Alternatively, the CHAP may be used toauthentication the connection of the devices.

Referring still to FIG. 22, the Quality-Protocol option may be a type 4quality protocol. Illustratively, the link quality monitoring feature isdisabled by default. Alternatively, the protocol may be enabled toprovide quality monitoring. Magic-Number option is a type 5 isillustrative not negotiated and is not used in the illustrativedefibrillator to utility module connection. TheProtocol-Field-Compression option is a type 7 protocol fieldcompression. Compression may be utilized to optimize availablebandwidth.

Address-and-Control-Field-Compression option is illustratively a type 8address and control field compression.

Still referring to FIG. 22, Network Control Protocol (NCP) supports theencapsulation of many different layer three datagram types. Some ofthese require additional setup before the link can be activated. Afterthe general link setup is completed with LCP, control is passed to thePPP NCP specific to the layer three protocol being used on the PPP link.As IP at the network layer level is used over the PPP connection,Internet Protocol Control Protocol (IPCP (RFC 1332)) is used as the NCP.The link will remain configured explicit LCP or NCP packets close thelink down, or some external event occurs (such as holding CTS low, orsome inactivity timer expires).

Alternatively, the Network Control Protocol may include an IP-Address oftype 3; an IP-Compression-Protocol of type 2; and Other Options 1233such as DNS Server could also be used; albeit in the above indicatedexample, these features are not used

The data transmission speeds of LCP and NCP may be determined by restarttimers (not shown) which may be used to set and change the data transferspeed between the defibrillator and the utility module for itself or asproxy to an external device.

FIG. 23 shows a process for configuring PPP LCP 1239 for setting up,maintaining, and terminating the link between devices such as thedefibrillator and the utility module and between the utility module andan external device when the utility module is acting as proxy for theexternal device in connection with communications between the externaldevice and the defibrillator. At the start of the process, there are nocommunication links established between the utility module and thedefibrillator. At this point, the PPP LCP process 1239 detects theexistence of no links between the utility module and the defibrillator(i.e., link dead). When the data outlet 495 (see FIG. 4) receivesdefibrillator data connect port 440 (see FIG. 4), the PPP LCP process1239 detects the physical connection between the defibrillator and theutility module and the PCP LCP protocol attempts to establish acommunication link between the defibrillator and the utility module. Ifthe PCP LCP protocol is unsuccessful in establishing the communicationlink between the defibrillator and the utility module, the PCP LCPprotocol returns to the link dead state to again wait to detect thephysical connection between the defibrillator and the utility module. Ifthe PCP LCP protocol is successful in establishing the communicationlink between the defibrillator and the utility module, the PCP LCPprotocol advances to a step of establishing the communication linkbetween the defibrillator and the utility module. This step is shown asa link established in the physical layer. In the PCP LCP process 1239,the PCP LCP advances to the step of authenticating the particulardefibrillator as a device that is authorized to be used with theparticular utility module and vice-versa (i.e., authenticating that theparticular utility module is authorized to be used with the particulardefibrillator.) If the PCP LCP fails to authenticate that thedefibrillator and the utility module are authorized to be used with eachother, the PCP LCP process 1239 advances to a link termination stepwhereby the PCP LCP proceeds to terminate the LCP link. This step isshown as LCP link. If the PCP LCP process successfully authenticates theuse of the defibrillator and the utility module with each other (or ifno authentication is required), the PCP LCP process 1239 advances to thenetwork layer protocol. The step of successful authentication is shownas an authenticated LCP link. The PCP LCP process then advances tonegotiate a successful NCP configuration. If unsuccessful, the PCP LSPprocess 1239 terminates the link. If the NCP configuration issuccessfully negotiated, the process 1239 advances to an open link. Inthe process 1239, the negotiation of NCP configuration is shown asauthenticated LCP link and NCP links.

Referring again to FIG. 21, illustratively, Network Layer 3 isillustratively internet protocol version 4 for providing switching androuting technologies, creating logical paths, known as virtual circuits,for transmitting data from node to node in networks. Routing andforwarding are functions of this layer, as well as addressing,internetworking, error handling, congestion control and packetsequencing are well known in the art. More specifically, the networklayer interface between defibrillator and the utility module is theInternet Protocol (IP or IPv4) as described by RFC 791. It isresponsible for logical device addressing, data packaging, manipulation,and delivery and routing. In addition, the network layer interface mayinclude ICMP (Internet Control Message Protocol; RFC 792) as an integralpart of IP. It is typically used to send error messages such as when adatagram cannot reach its destination. In an illustrative peer-to-peerembodiment, the ICMP is not used. However, in alternative embodiments ofpeer-to-peer and otherwise, the ICMP may be useful in providing messagecontrol for communications. The IP header includes a number of itemsincluding the source and destination addresses. The defibrillator willillustrative utilize a unique IP address. The utility module willutilize another unique IP address. Both of these addresses areillustratively within the block of IP addresses reserved for privateinternets per RFC 1918.

Transport Layer 4 is illustratively a transmission protocol (TCP) forproviding transparent transfer of data between end systems, or hosts.TCP is responsible for end-to-end error recovery and flow control andensuring complete data transfer and is well known in the art. Morespecifically, Transport Layer (4) between the defibrillator and theutility module will be Transmission Control Protocol (TCP) as describedby RFC 793. It is used to guarantee the delivery of the message orentire files. TCP assumes that an IP protocol is available at the lowerlevels of the communication stack. Illustratively, the FTP utilizes TCPto guarantee the delivery of entire files.

Session Layer 5 and Presentation Layer 6 are illustratively not used inthe illustrative embodiment. Alternatively, Session Layer 5 andPresentation Layer 6 may be used on alternative embodiments. The SessionLayer 5 establishes, manages and terminates connections betweenapplications. The session layer sets up, coordinates, and terminatesconversations, exchanges, and dialogues between the applications at eachend and deals with session and connection coordination. The PresentationLayer 6, sometimes called the syntax layer, provides independence fromdifferences in data representation (e.g., encryption) by translatingfrom application to network format, and vice versa. The presentationlayer works to transform data into the form that the application layercan accept and formats and encrypts data to be sent across a network,providing freedom from compatibility problems. Both Session Layer 5 andPresentation Layer 6 are well known in the art.

Application Layer 7 supports application and end-user processes.Application layers may include applications for e-mail, news-groups, webapplications, file transfer, host sessions, directory services, networkmanagement, file services, and other network services. Theseapplications identify communication partners, quality of service, userauthentication and privacy, and any constraints on data syntax. Thislayer of application-specific and end user processes is well known inthe art.

More specifically with respect to Application Layer (7) in theillustrative embodiment, the defibrillator and the utility moduleillustratively communicate in normal mode data via sockets—except whenthe device is passing through test interface commands—and the utilitymodule will pull stored patient data and device test reports via FTP.FTP is described by RFC 959 (updated by 2228 (FTP Security Extensions),2640 (Internationalization of the File Transfer Protocol)). RFC 2773(Encryption using KEA and SKIPJACK) is not used in the illustrativeembodiment but may be used in alternative embodiments to provide moreencryption functionality.

Illustratively, FTP is used only to retrieve patient and device recordswhen the defibrillator is not actively being used on a patient. In theFTP protocol configuration, the defibrillator is configured to act asthe FTP server, and utilizes a username and a password for accesscontrol. Supported FTP commands are listed in the FTP protocol.Illustratively, commands may include commands to read or access data orto create or delete directories and files may be utilized or supported.The utility module may retrieve the current content of the attacheddefibrillator through commands that determine which files/records toretrieve including device test logs and patient records.

If the defibrillator transitions from a normal mode into an archivesmode, then the utility module may repeatedly issue commands looking fora request to send a patient record denoted by content in an outboxelement. The defibrillator may identify files that it wants to transmit(if any) by populating an outbox element. The utility module mayretrieve the indicated record(s) through commands. After an outbox fileis retrieved, the defibrillator may remove it from subsequent directoryobjects.

If the defibrillator startup reason is in a self test and the self testis complete, the utility module may retrieve the directory of unsentrecords by getting the directory object. The utility module may utilizethe content of the directory object to successively retrieve thecontinuous ECG and code summary records for each unsent patient record(as noted by a record previously sent record attribute) using FTPcommands. After all unsent patient records are retrieved, the utilitymodule may also retrieve the device test log record using an FTPcommand.

Regardless of the startup reason, after a patient record has beenretrieved by the utility module, and the utility module has successfullytransmitted the record to an external device, the utility module maytransmit commands to the defibrillator to mark a record as being sent.Subsequent directory object contents may indicate that the record hasbeen sent to prevent repeated transmissions. When the defibrillatorstartup reason is a self test and all unsent records have been retrievedand transmitted to a network system, such as a network server, or whenthe network system link is no longer available, the utility module maycommand the device to shutdown through a test interface command.

Sockets are primarily a concept used within the Transport Layer. Withthe addition of custom data, these become layer-like messages. AnIPv4/stream/TCP socket (described by RFC 147) will be created by theutility module to carry bi-directional messages between thedefibrillator and the utility module. A predetermined port mayillustratively be used. The utility module will act as the server, andwill listen for connections. The defibrillator will connect to thesocket created by the utility module. After a connection has beenestablished, periodic messages will be exchanged during normal mode asdetailed in the following sections.

Message Framing and Encoding. Messages are passed through a TCP basedsocket which includes its own framing and guaranteed delivery so noadditional framing is required. Multiple messages can be sent in asingle transmission as the receiver sees the messages as a simple streamof bytes.

Check Value. Although each message is transported by protocols to ensurethe integrity of the message, a check value can be used to determine ifan invalid message was generated at the source, or corrupted by thereceiver after reception.

Message Rates. The Monitoring Mode (CO2 waveform) is illustratively 5Hz. The overall message rate of the system is driven by the CO2 samplerate. The CO2 module samples waveform data at 20 Hz (i.e., every 50 ms).Hence, illustratively after every 4 samples the utility module CO2Waveform message (2001) normal mode message is sent from the utilitymodule to the defibrillator (i.e., every 200 ms). If the utility moduledoes not have the CO2 Module or this module has a malfunction, theutility module will send a null message.

FTP Data Transfer Mode. The FTP data transfer mode is illustratively 1Hz. In FTP Data Transfer Mode, messaging is reduced to 1 hz and messagetraffic is reduced to increase bandwidth available for FTP datatransfers. The utility module Device Data Transfer Status packets aresent at a data rate of 1 hz. The defibrillator illustratively sendsDevice Status packets at 1 hz.

FIG. 24 shows illustrative data links 1270 using the hardware andsoftware architecture 1100 of FIG. 21 of this disclosure. Data links1270 includes physical layer, data layer, network layer, and applicationlayer. Physical layer includes a data connect COM0; physical connectorCOM1 to a communication module 490, physical connector COM2 to acapnography module, an MMC17 Wi-Fi connect to a server; a USB PORT 1 toan adjunct medical device; a GPIO connect to LEDS and temperature fan;and an SMBus connect to a battery. These pieces of hardware connectthrough drivers to an OS abstraction or an interface,. The OSAbstraction creates sockets and commands to connect the data to and theintermediary driver also connects data to the application space. Theapplication space comprises a variety of applications such asdefibrillator application, LDA application, capno application, serverapplication, adjunct medical device application, accessory application.For instance, the LDA application supports application and end-userprocesses for the device agent. The server application supportsapplication and end-user processes for the server 910, allowing for thebidirectional exchange of data between socket and message queues.

As discussed in connection with the FIGS. above, an RS232 serialconnection is illustratively used for data communications between theutility module and the defibrillator. More specifically, thebidirectional data 441 travels over a hardwire connection that isestablished once the defibrillator data connect port 440 of thedefibrillator is received by the data outlet 475 of the utility moduleas discussed in FIG. 4. Advantageously, the RS-232 serial connectionuses two different protocols during the communication sessions. Theutility module initializes its serial port on its power on to providetest interface functionality which is described in connection with FIG.20 as the test interface commands. The foregoing test interface commandsand responses may be used by external devices to communicate with thedefibrillator through the utility module at the manufacturing testinterface level. In this case, the utility module acts as a pass-throughfor all test interface commands between an external device and thedefibrillator. The test interface commands and responses and the PPPprotocol commands can occur contemporaneously. In other words, theforegoing pass-through can occur with the PPP protocol running orwithout the PPP protocol. The external devices that may initiate andrespond to test interface commands may include the device agent, thecapnography unit, the server 810, and the adjunct medical device 850described in connection with FIG. 14. In addition, the utility modulemay also use the foregoing test interface commands and responses for itsown communication with the defibrillator. Hence, the utility module isconfigured to communicate with the defibrillator for its own purposes aswell as to communicate for the external devices by proxy using testinterface test interface commands.

To enable a Point-to-Point (PPP) connection between the defibrillatorand the utility module, the disclosed hardware and architecture of FIG.21 advantageously dedicates one or more of the test interface commandsto enabling a Point-to-Point (PPP) connection between the defibrillatorand the utility module. PPP is used as a data link layer protocol usedto support IP network layer connections, TCP transport layer connectionsand FTP application layer connections. Illustratively, one testinterface command is used to initiate a Point-to-Point Protocol (PPP)direct communication in the illustrative disclosure of FIG. 21. Hence,the RS-232 serial communication between the utility module and thedefibrillator utilizes test interface commands to both perform testinterface level communications between the utility module and thedefibrillator and between external devices and the defibrillator throughthe utility module acting as proxy to the external devices and PPP levelcommunications between the defibrillator and the utility module for useby the utility module itself or as a proxy to one or more externaldevices.

The PPP command enables the communication between the defibrillator andthe utility module for use by the utility module itself or with theutility module acting as proxy to one or more external devices. The datagenerated by the PPP command is network enabling, that is, useful forcommunicating over the network. As described in connection with FIG. 20,this network enabling data may include defibrillator device self teststatus data; utility module data transfer status data; a device statusdata that each of the utility module and defibrillator, respectively,may send to the other to indicate the status of the device; patientepisode data that the defibrillator may send to the utility module; CO2waveform data that the utility module may send to the defibrillator; andvital signs data that each of the utility module and defibrillator,respectively, may send each other.

As previously discussed, this network enabling data enables these andother network based communications to occur between the defibrillatorand the utility module in connection with the exchange of network baseddata between the defibrillator and the utility module and in connectionwith the exchange of network based data between the defibrillator andthe utility module when acting as proxy for one or more external devices(i.e., for the utility module to pass through to the external devices.)

Referring still to FIG. 20, one network based communication between thedefibrillator and the utility module when acting as proxy for one ormore external devices may be enabled by the device self test status datawhich is a command that originates from the defibrillator to the utilitymodule. With the device self test status command, the defibrillatortells the utility module that it is ready to download data that iscontained in defibrillator (such as in the memory unit 430 of thedefibrillator 410 as shown in FIG. 4) to the utility module for theutility module to store or to pass through as proxy to an externaldevice.

One application that takes advantage of the device self test data is theserver application shown in FIG. 24. The server application is shown inFIG. 24 residing in the application space of the hardware and systemarchitecture implementing data links 1270 using the utility module 455as shown in FIG. 24. Advantageously, the server application may providean event service that allows for the scheduled downloading of data fromthe defibrillator for storage in the utility module or for pass-throughto an external device through the utility module acting as proxy for theexternal device. In either case, the utility module processor 480 (FIG.4) may be configured to execute the instance of the event serviceprovided by the server application shown in FIG. 24 in order to providedata communications from the defibrillator to the utility module or toan external device through the utility module acting as proxy. In oneillustrative embodiment, the external device may be the server 810 ofFIG. 14. Hence, the event service may be used to enable datacommunications to pass from the defibrillator to the utility module foruse by the utility module or to the external device, through the utilitymodule acting as proxy, for use by the external device.

In the foregoing example, the server event service that enablesscheduled downloading of data communications from the defibrillatorresides on the utility module as a client. Alternatively, the eventservice that provides data communications from the utility module may beconfigured to reside on a computer such as the utility applications(computer) 820 shown in FIG. 14. In either case, this event servicingapplication providing the instructions for controlling processor 480 ofthe utility module to download defibrillator data advantageously enablesthe defibrillator system of this disclosure to provide scheduleddownloads of defibrillator data to the utility module or to the externaldevice through the utility module acting as a proxy.

Advantageously, the transmission of the data by the event service thatenables data communications from the defibrillator to the utility moduleto either use or pass through to an external device may occur at apredetermined period of time. The predetermined period of time at whichthe transmission of data by the event service that provides datacommunications from the utility module from the defibrillator mayillustratively occur substantially at or about 3 o'clock in the morning.Illustratively, the 3 o'clock in the morning time may be based on thetime zone in which the defibrillator is being used. This allows thedownload of data from the defibrillator to occur at a time of the daywhen the defibrillator is least likely to be used. Where a defibrillatorsystem of this disclosure is being managed across several time zones,the 3 o'clock in the morning time may be based on one of the time zoneswithin that managed region.

While the preferred time of day for the download of data to occur is ator around 3 o'clock in the morning for the reasons previously discussed,it will be appreciated that the predetermined period of time at whichthe transmission of data by the event service that provides datacommunications from the utility module from the defibrillator may beother than 3 o'clock in the morning and may also be managed in otherways. For instance, the predetermined period of time at which thetransmission of data by the event service that provides datacommunications from the utility module from the defibrillator may bescheduled to occur once a day. Alternatively, it may be scheduled tooccur more than once a day. In addition, it may be scheduled to occurevery other day, weekly, or at other regular or irregular periods oftime. Where irregular periods of time are used, a random numbergenerator may be used to instruct the event service what time to makethe downloads each day. As another example, the predetermined period oftime at which the transmission of data by the event service thatprovides data communications from the utility module from thedefibrillator may occur between the hours of midnight and 6am in themorning. The defibrillator may come from the factory preprogrammed witha specific time for the download to occur. Alternatively, the specifictime may be provided to the defibrillator at a later point in time inconnection with an update to software or configuration settings.Illustratively, the specific time may be included in rules that may bedownloaded to a defibrillator at any time. For instance, a rule mayprescribe that the download is to occur at 3 o'clock in the morningunless the defibrillator is being used at that time. If thedefibrillator is being used at 3 o'clock in the morning, the rule mayprescribe that the download will occur at a predetermined period of timeafter the defibrillator has last been used. If this programmedpredetermined period of time after defibrillator use is one hour and thelast activity of the defibrillator is confirmed by the utility module tobe 3:27 am, then the foregoing rule would schedule the next download ofdata one hour later, or at 4:27 am in the morning, on the same day.

As previously indicated, the transmission of the data by the eventservice that provides data communications from the utility module fromthe defibrillator may be to a server. Alternatively, it may be to acomputer which is not configured to serve other computers. In the eventthe communication of the downloaded data from the defibrillator is toserver 810 as shown in FIG. 14, the download to the server may be withina private network or may occur over the public network such as over theinternet. In the case of a download of data over a public network, thetransmission may occur through gateway as shown and described inconnection with FIG. 19.

Turning now to the operation of the data communication link of thedefibrillator system of this disclosure, upon defibrillator and utilitymodule startup or after a controlled reset, the baud rate isillustratively reset to a baseline baud rate. The baseline baud ratewill serve as the baud rate for the communications between thedefibrillator and the utility module communication and also between boththe defibrillator and the utility module and an external device. Theutility module will utilize a test interface command to initiatechanging the baud rate and the defibrillator will respond, and both thedefibrillator and the utility module will switch baud rates. After ashort time delay, the utility module will utilize a command to confirmthat the baud rate switch has been made. The test interface commands areused by the defibrillator and the utility module and the externaldevices in initiating and effecting these communications.. Adefibrillator and utility module is configured to respond to thecommands the same way with or without the utility module connected tothe defibrillator. To accommodate this, the utility module may act as apass-through for all existing test interface commands—this can occurwith the PPP protocol running or without the PPP protocol running. Inthis embodiment, the utility module will intercept new commands, as wellas other commands normally intended for the defibrillator.

On power up, the defibrillator sends an ASCII banner over the testinterface. Following receipt of the banner, the utility module can usetest interface commands to request information it needs from thedefibrillator. The utility module may respond to the banner by sendingthe open and external commands. Depending upon the utility moduleoperating mode, various other commands may be issued. For example, thecommunications baud rate will be changed using a specific command, and anormal mode communications session will be established using a utilitymodule initiate command. Additional defibrillator and utility modulecommands may be used.

Intercepted Test Interface Commands. The utility module contains anexternal serial port that is intended to replicate the functionality ofthe defibrillator's external serial port. This serial port may be usedby external components and programs such as the utility applications(computer) 820 (FIG. 14) that includes a device agent to communicatewith and control the defibrillator and utility module. All commands froman external device except those described below will be passed throughto the defibrillator device for handling when the device is in normalmode and the utility module is not utilizing the test interface of thedevice. For example, with a specified external device command, theutility module will intercept the external command, and respond that thetest interface is now accessible. The utility module will respond tosubsequent external commands with an error message. With the baud rateselect command (except as noted later), the utility module will respondto the external program as if the defibrillator was responding andchange its communication rate on the external serial port accordingly.With a reboot command, the utility module will pass the reboot commandthrough to the defibrillator, but in addition the utility module willreset its external baud rate. The utility module will respond toexternal commands when utility module is utilizing the test interfacecommand with a message that the external device command is not accepted.The utility module will transmit a command prompt on the external serialport whenever it receives a banner from the defibrillator on itsinternal serial port

Pass-Through Operation. There is a need for the utility module toquickly pass-through test interface commands from an external device tothe defibrillator without interference (for example, when performing asoftware load through the utility module). To accomplish this, when theutility module receives an open command on the external serial port andthe defibrillator is powered on, the utility module will stop respondingto the utility module command and send a stop command to thedefibrillator so that defibrillator also stops sending the utilitymodule command. The defibrillator will respond to the utility modulewith a command prompt. Upon receipt of the command prompt, the utilitymodule will transmit the opened response on the external serial port.

FIG. 25 further illustrates the operation 1300 of the open command 1318on the external serial port. More specifically, FIG. 25 illustrates theoperation of the open command 1318 in a communication session occurringbetween the utility module 1312 and defibrillator 1310. The open command1318 is initiated by an external application 1314 such as a device agentof utility applications (e.g., device agent or other applications) 820(FIG. 14), a parameter module 460 (FIG. 5), a server 810 (FIG. 14), oran adjunct medical device 850. Prior to the time the open command 1318is initiated by the external application, FIG. 25 shows a communicationsession 1316 involving the bidirectional flow of data occurring betweenthe defibrillator and the utility module. When the open command 1318 isreceived by the utility module, the utility module immediately issues astop command 1320 to the defibrillator 1310. The defibrillatorimmediately responds by sending the utility module 1312 an acknowledgecommand 1322. On receipt, the utility module sends the externalapplication an opened signal 1324 which then configures the utilitymodule to quickly pass-through test interface commands from the externalapplication 1314 to the defibrillator without interference.

More specifically, at that point, the utility module will enter intopass-through operation—examining each command received from the externalport, responding to commands meant for the utility module,passing-through all other commands to the defibrillator and passing-backthe defibrillator response to the external serial port. Illustratively,when in pass-through operation, certain commands may require specialprocessing. When this occurs, external programs are not able to sendtest interface commands and see CO2 data on the defibrillator at thesame time. However, if this need may exist for verification teams, thecommunication between the utility module and the defibrillator may bere-established using a utility module initiate command. Upon receipt ofthis command, the utility module will initiate communication with thedefibrillator using the utility module command.

If the defibrillator is not powered on when the open command is sent,the utility module will transmit the opened signal response on theexternal serial port. The utility module will then respond normally tocommands meant for the utility module and give no response to othercommands. The utility module response to defibrillator commands (noresponse) simulates the performance of the defibrillator when poweredoff.

Networked Interface. During normal operations, the defibrillator and theutility module will communicate with each other over a networking basedconnection. This mode of operation will be initiated by the utilitymodule with the defibrillator utility module initiate command. Therelationship of the various communication layers to each other have beenpreviously described in connection with FIG. 21. The utility module andthe defibrillator illustratively implement those layers/protocols aspreviously discussed in connection with FIG. 21.

In an illustrative message stream for CO2 data transmitted from theutility to the defibrillator from the utility module to thedefibrillator, the normal mode message may be sent from the utilitymodule to the defibrillator at a periodic interval. If the CO2 Module ispresent and operating normally, this timing will be driven upon receiptof a periodic sample. If the CO2 Module is not present or has amalfunction, the utility module will emit this message on its owninternal timing. The CO2 messages are illustratively sent at a rate of 5Hz assuming that waveform data is sampled by the CO2 module at a 20 Hzrate which allows for one message to be sent on the sampling of thefourth sample. The message is conveyed by the utility module when thedefibrillator is in a normal mode of operation and continues until FTPis started. When FTP is started the FTP protocol messaging preempts theCO2 messaging as described below. The CO2 waveform is sent only when theutility module is present and there is no major malfunction of the CO2module. A null message is sent when the utility module does not containCO2 or a major malfunction is detected within the utility module.

The incremented sample numbers are encapsulated into CO2 data fields andencapsulated by an IP header field and a TCP header field forcontrolling the path of the message according to the IP and TCPprotocols. The encapsulated data message is sent from the utility moduleto the defibrillator through the physical layer with an address field,control field, protocol field, check bits, and flag controlling thedestination and path taken by the message from the utility module to thedefibrillator through the physical layer.

As another illustrative example, the utility module may send vital signsto the defibrillator. The vital signs may include ambient pressure,breath detected, EtCO2 value, FiCO2 value, respiration rate, IPI, andCRC. Using appropriate sampling rates, this data may be encapsulatedinto the IP and TCP header fields and further encapsulated into thephysical layer fields to enable the routing of the vital signs messagethrough the network layer down to the physical layer of the utilitymodule and then over to the physical layer of the defibrillator forpassing up to the network layer of the defibrillator for use by thedefibrillator.

Illustratively, the utility module device status control signal isencapsulated with network and physical layer protocol information in amanner similar to the manner described above. In the case of devicecontrol status, the data includes information like the power status ofthe battery of the utility module.

The test interface commands include fields on the type of message,length of message, and the test interface command itself. The utilitymodule transfer status message includes fields on the type and length ofmessage, as well as a battery status indicator which causes thedefibrillator to display a “Low Battery: Connect AC Power” message onthe defibrillator display. Other messages may be sent between theutility module and the defibrillator in order for the utility module tocoach the user of the defibrillator to perform a more effectivedefibrillation.

Similarly, in an illustrative message stream for SpO2 and HR data, thenormal mode message is sent from the defibrillator to the utility moduleat a prescribed time interval. The messages with the HR and SpO2 dataare illustratively sent at a rate that is slower than the rate at whichthe waveform data is sampled by the defibrillator. The message isconveyed by the defibrillator when the utility module is in a normalmode of operation and continues until FTP is started. When FTP isstarted the FTP protocol messaging preempts the messaging as describedbelow. The waveform is sent only when the defibrillator is present andthere is no malfunction of the HR and SpO2 module of the defibrillator.

The HR sample number is encapsulated in HR field and the SpO2 samplenumber is encapsulated in SpO2 field. The encapsulated HR and SpO2 datafields are encapsulated by the IP header field and TCP header field forcontrolling the path of the message according to the IP and TCPprotocols. The encapsulated data message is sent from the defibrillatorto the utility module through the physical layer with the flag field,address field, control field, protocol field, check bits, and flagcontrolling the destination and path taken by the message from thedefibrillator to the utility module through the physical layer.

As another illustrative example, the defibrillator may send vital signsto the utility module. The vital signs may include ambient pressure,breath detected, EtCO2 value, FiCO2 value, respiration rate, IPI, SpO2,pulse rate, and CRC. Using appropriate sampling rates, this data may beencapsulated into the IP and TCP header fields, and further encapsulatedinto the physical layer fields to enable the routing of the vital signsmessage through the network layer down to the physical layer of thedefibrillator and then over to the physical layer of the utility modulefor passing up to the network layer of the defibrillator for use by thedefibrillator.

Illustratively, the utility module device status control signal isencapsulated with network and physical layer protocol information in amanner similar to the manner described above. In the case of devicecontrol status, the data includes information like the monitoring statusof the utility module (i.e., manual or AED), power status of the batteryof the defibrillator.

FIG. 26 shows a possible relationship of events for user power on of adefibrillator 1404 that is in electrical connection with a utilitymodule. At step 1410, the user 1402 powers on the defibrillator 1404. Onpower on, the defibrillator 1404 exchanges messages 1411 with theutility module 1406. A service application on a computer 1409 externalto the utility module sends the utility module an open command 1412, andso on. The command can be applied to the serial port of the utilitymodule (1050 in FIG. 20) that is configured to receive serial commandsfrom external devices. In the illustrative embodiment shown in FIG. 26,the utility module is configured with a CO2 parameter module whichoperates in a manner previously discussed. The defibrillator can start aPPP client and then initiate a PPP connections message. The utilitymodule is acting as the server to the defibrillator; listening for theseconnections. The defibrillator connects to a data socket created by theutility module and connects to the utility module control channel. Theutility module connects to a data socket created by the defibrillatorand connects to the defibrillator control channel. Throughout thisprocess, the defibrillator could be polling the utility module toconfirm that the foregoing connections have been made. With the SpO2, PRchannel and the CO2 sockets open between defibrillator and utilitymodule, the defibrillator begins to send SpO2, PR data to the utilitymodule over the SpO2, PR data socket. The defibrillator controls thedata transfer over that socket at a predetermined data rate using theutility module control channel. In addition, the utility module beginsto send CO2 data to the defibrillator over the CO2 data socket. Theutility module controls the data transfer over that socket at apredetermined data rate using the defibrillator control channel. Theforegoing bidirectional flow of data between the defibrillator and theutility module continue until terminated by the operator.

FIG. 27 shows an illustrative communication sequence 1450 between theutility module and the defibrillator. The file transfer mode ofoperation between the defibrillator and the utility module of FIG. 5 isactivated by a send data command 1460. Prior to a notify utility modulecommand 1462, there is a bidirectional flow of data 1461 between thedefibrillator and the utility module that may occur during a patientmonitoring mode of operation as described above, whether or not thedefibrillator is being used in a patient monitoring procedure. Messagesfrom the defibrillator have an FTP byte flagged off since there is notransfer of FTP files in the illustrated patient monitoring mode ofoperation in this illustration. With the send data activated command1460, the file transfer mode of operation has been activated.Illustratively, this activation may occur by a user pressing anactivation button on the defibrillator interface 1452. Alternatively,this activation may occur by trigger signals that may be generatedinternally to the defibrillator, such as by programmed software.Alternatively, the trigger signals may be generated by the utilitymodule or by an external device for application to the defibrillator byor through the utility module for providing a synchronous orasynchronous download of patient data and/or defibrillator settings foruse by the utility module or the external device.

On activation of the activating the file transfer mode of operationbetween the defibrillator and the utility module, the user interface1452 in this example, prompts the defibrillator with a command 1462 tochange to a file transfer mode of operation. In response, thedefibrillator changes over to a file transfer mode of operation. In thismode of operation, the defibrillator begins the transmission of an FTPfile illustratively of patient and/or configuration settings. A filemessage is transmitted from the defibrillator to the utility module. Byprotocol, the utility module recognizes a message to be file data by theFTP byte which is flagged-on for file data messages. In the example, theutility module recognizes the message from the defibrillator to be afile message since the FTP byte of this message is flagged-on.

While the defibrillator is transmitting FTP files to the utility module,the utility module illustratively responds by sending messages back tothe defibrillator indicating the status of the file download. Thedefibrillator continues to send the FTP file. The utility modulecontinues to recognize this message to be a message file since the FTPbyte of the message is flagged-on. The utility module continues totransmit messages back 1463 to the defibrillator on the status of thefile download. Throughout this process, the utility module continuesmonitoring the FTP Byte of messages received from the defibrillator inorder to know when the defibrillator has finished downloading its file.When the utility module recognizes that an FTP file has been downloaded,by detecting the flag-off of the FTP Byte in incoming messages, theutility module flags-on a byte of its download status message toindicate the success or failure of the FTP file download. On receipt ofthis message, the defibrillator illustratively sends the defibrillatoruser interface a notify transmission success or fail command 1464 forthe purpose of alerting the user that the FTP file download has beensuccessful or a failure so that the user can have tranquility that thefile was successfully downloaded or re-activate the file downloadprocess in order to try to download the file again. After the userinterface has been alerted on the success or failure of the download,the defibrillator switches from file transfer mode back to patientmonitoring mode of operation whereupon the defibrillator returns tosending message data to the utility module. In this example, the FTPbyte is flagged-off; indicating to the utility module that the messageis a data and not a file message. The utility module returns to patientmonitoring mode of operation whereupon the utility module resumessending its data messages.

Advantageously, the file download enables external devices and/or theutility module to provide more informed coaching to a user of thedefibrillator by enabling information available in downloaded patientdata and configuration setting files to be used in coaching a userduring a defibrillation process. In addition, with real-time download ofbatch patient and setting configuration information made possible bythis disclosure, medical personnel have this information immediateavailability for use in post-defibrillation treatment, instead of havingto wait to retrieve this information after the defibrillation process isover and the data is downloaded. In addition, by having the real-timedata of this disclosure to observe during a defibrillation process,medical personnel may understand better the correlation of patient vitaldata to the defibrillation data which can lead to better coachingtechniques. These and other purposes are served by the real-timedownload of batch data from a defibrillator of this disclosure.

In the above example, the data from the utility module to thedefibrillator is dedicated to informing the defibrillator on the statusof the file download. In alternative embodiments, the utility module maycontinue transmitting data to the defibrillator while at the same timemonitoring the file download and providing status on the file downloadto the defibrillator. Advantageously, this allows real-time utilitymodule data, such as CO2 data, to continue to be streamed from theutility module to the defibrillator while the defibrillator isdownloading the file data. Hence, utility module and/or the externaldevices through the utility module are enabled in this embodiment tocontinue coaching a user during a defibrillation process during downloadof these files

In an alternative embodiment, the utility module may further include amotion sensor (not shown) configured to detect a change in position ofthe utility module relative to its surroundings. Illustratively, themotion sensor is an accelerometer. Alternatively, the motion sensor maybe any sensor configured to detect a change in motion by electrical,mechanical, or other methods.

Information from the motion sensor may be used to optimize theperformance of the utility module and the coaching that is made possibleusing the utility module. For example, the user of a utility module maybe coached by one or more external devices to move the utility module ina specified direction for advantage. For example, information from asensor in a utility module in an ambulance vehicle may be used by thesystem to provide instructions to the driver of the vehicle on whichhospital a patient should be taken to. As another example, the systemmay use the information to instruct the user of a utility module toreposition the utility module for better operation, such as to move theutility module to a position where it may receive better reception of awireless signal or where it may provide better coaching to thedefibrillator. For example, if a utility module is optimized for usewithin a restricted area, information from the sensor may be used toalert the user that the utility module has been moved outside theoptimum area so that the user may take corrective action in order toimprove the defibrillation process.

Information from the sensor may also be used to protect the utilitymodule and to make it more secure. For instance, in the above example,the information that is generated by the sensor in the case of a breachof the restricted area by a user may be used to secure the device. Forexample, on the occurrence of the breach, the utility module may beprogrammed to do an automatic power-down or to enter a sleep modeoperation of the device until the security breach is corrected.Alternatively, the event may trigger an alarm on the utility moduleand/or at an external device in order that action may be taken to makethe utility module secure.

In an alternative embodiment, the communication module 490 shown in FIG.4 may include a Radio Frequency Identification (“RFID”) reader, whichcan also be called an on-board RFID reader. The on-board RFID reader maybe configured for communicating with RFID tags, or another RFID reader,for the purpose of automatic identification and tracking. The RFID tagsand the other RFID reader may be attached to objects in the environmentexternal to the utility module. The environment may be any location inwhich the utility module is designed to be found, such as a location fortesting the manufacture of the device, an ambulance, a hospital or otherpatient care center, etc. The RFID reader enables the utility module todiscern where it is located with respect to its environment in order touse this information for enabling a more effective defibrillationprocess. For instance, if defibrillation is being performed in an officebuilding by non-medical personnel, the RFID reader may alert the rescuerthat a trained medical personnel is nearby in another office to assistbecause the RFID reader has detected an RFID tag embedded in anidentification card carried by the medical personnel in the nearbyoffice.

In an alternative embodiment, the communications module 491 shown inFIG. 4, other components of the utility module, and/or the housing ofthe utility module may include an RFID tag, which can also be called astatus RFID tag. The RFID tag may be used for automatic identificationand tracking of the utility module by an RFID reader external to theutility module. This tracking information may enable the network that isconnected to the utility monitor to factor tracking information into thecoaching that the network may provide the defibrillator.

In another embodiment, the utility module includes both an on-board RFIDreader and a status RFID tag. The on-board RFID reader may be configuredto provide or update data residing on the status RFID tag concerningpatient data, configuration settings, etc. This updated patient data,configuration settings, etc. available to the utility module, includingfrom the defibrillator or an external device, becomes available to anRFID system for automatic identification and tracking each time the RFIDsystem interrogates the RFID tag by an external RFID reader. Hence, anRFID system for identifying and tracking utility modules may be improvedsince the RFID system is being synchronized with an RFID tag which isbeing updated by the internal RFID reader with more frequency. Thisresult is an RFID system that contains data that is more current thanthe data that is internal to utility modules. In addition, any dataavailable to the utility module may be immediately written onto thestatus RFID tag by the on-board RFID reader and picked up by an externalRFID reader more quickly; thereby providing the RFID system also withthe most current data on the utility module. These and other RFIDfeatures of this disclosure enables improved identification and trackingof the utility module in the RFID system which in turn enables improvedcoaching. For example, the system may use the feedback information fromthe RFID system to instruct the user of a utility module to repositionthe utility module for better operation, such as to move the utilitymodule to a position where it may receive better reception of a wirelesssignal or where it may provide better coaching to the defibrillator. Thesystem may also use the feedback from the RFID system to reconfiguresettings in the utility module or defibrillator or external devicesbeing used with the utility module in order to optimize the performanceof the utility module based on the RFID system feedback.

The RFID communication of this disclosure can occur at any suitablefrequency. Examples of such frequencies are centered around 130 KHz,13.56 MHz, 900 MHz, 2.4 GHz, and so on. The higher the frequency, thefaster the data communication will be. The RFID tags can be passive oractive. The RFID readers and passive RFID tags in the 900 MHz frequencyrange can be part of the standardized Class 1 Generation 2 UHF AirInterface Protocol, also known as the “Gen 2 Spec”. It will beappreciated that other RFID communication methods and protocols may alsobe used with this disclosure.

FIG. 28 shows an illustrative embodiment of the utility module of FIG. 5with a power management module 550. FIG. 28 shows a utility module 1500which contains many of the components appearing in FIG. 5 (whosefunction and operation are as described in FIG. 5), except that thepower manager 550 of FIG. 5 that is shown in FIG. 28 has been explodedto show the components that illustratively make up the power manager. Asshown, AC power is provided to power manager 550 by grounded AC inputconnector 1512. Grounded AC out connector 1530 is configured to allow ACpower that is input to the utility module by AC input connector 1512 tobe output via out connector 1530 for use by another utility module or adefibrillator. In one embodiment, AC input connector 1512 is a plug forreceiving input power over a power cord (not shown) from an AC outlet..In one embodiment, AC out connector 1530 is a socket connector formedespecially for fitting into a portion of the utility module bridge backand then connecting to the rear of a defibrillator to provide power tothe defibrillator. In one embodiment, AC out connector 1530 is a socketadapted for connecting with the plug portion of a standard power cord(not shown), with the socket portion of the power cord connecting to amating plug of another utility module. In one embodiment, connectors1512, 1530 are adjacent one another as shown, at the rear of utilitymodule 1500. Other embodiments with other plug or socket combinationsmay be used.

AC input connector 1512 and out connector 1530 each has a positive lead,a negative lead and a ground lead. The positive leads of AC connectors1512, 1530 are connected to power line 1514 to apply positive voltageonto AC-to-DC converter module 1520. The negative leads of AC connectors1512, 1530 are connected to power line 1516 to provide a negative leadfor AC-to-DC converter module 1520. Ground leads shown provide theAC-to-DC converter module 1520 with grounding. The output from theAC-to-DC converter module 1520, in this embodiment, is a 15 Volt outputto battery management IC 1522.

Battery management IC 1522 in this embodiment is an integrated circuit(IC) that interfaces with the module processor via I/O port 1527. Theinformation exchanged through this port enables module processor to keeptabs on the health of smart battery pack 1518 and to output a signalindicative of that health to the AC/battery LED shown in the FIG.Battery management IC 1522 receives power from the AC-to-DC convertermodule 1520 and outputs power to smart battery pack 1518 and to 3VDC-to-DC converter 1528 and 5V DC-to-DC converter 1526. Smart batterypack 1518 connects with a battery discharge switch 1524 and alsoconnects directly to module processor to supply power.

Smart battery pack 1518 is illustratively two Li-ion batteries. Thebatteries are charged by a charge from battery management IC 1522 thatis applied to smart battery pack 1518. The batteries apply their chargeto power the module processor. The battery management IC has anSMBUS/I2C interface to allow for this I2C port communication with themodule processor. Illustratively, the smart battery pack is batterypack, 3S1P, with Li-ion batteries, part number 102-003925-001, fromMicro Power Electronics, Inc., Beaverton, Oreg.

Battery management IC 1522 is controlled by module processor by controlsignals applied from port I2C of module processor to the batterymanagement IC 1522. Battery management IC 1572 applies a first signal tothe module processor and a second signal to battery discharge switch1524 for controlling the discharge of the smart battery pack 1518 duringconditions in which battery discharge is required. Power from the smartbattery pack is also applied to voltage converters 1526, 1528 whichconvert the (15 volt) DC power into 5 volt power and 3.3 volt power asshown. 3.3 volt power is applied to a first high-side switch 1532 and asecond high-side switch 1534. The first high-side switch 1532 provides3.3V power for application to the Wi-Fi module. The second high-sideswitch 1534 provides 3.3V power for application to the capnographymodule 1508.

Control signals from the module processor are issued through I/O ports1529 of the module processor. Both first and second high-side switches1532, 1534 are controlled by a control signal I/O port of the moduleprocessor. The first high-side switch 1532 is further controlled by asecond control signal coming from a second I/O port of the moduleprocessor. In addition, a third control signal 1543 coming from I/Oports of the module processor is applied to an ON/OFF logic circuit 1551of the power management module to control the ON/OFF state of thevoltage converters. The ON/OFF state of the utility module is alsocontrolled by a reset switch 1554 which connects on a downstream end toa ground line and on an upstream end to a switch debouncer circuit 1553which generates the ON/OFF state signal that is applied to the ON/OFFlogic circuit 1551 to turn the Wi-Fi module and capnography moduleON/OFF in response to the action of the reset switch 1554. The action ofthe reset switch 1554 also triggers a utility module reset logic circuit1552 which puts a reset signal to reset port of the module processor.

In operation, the utility module 1500 preferably is powered by AC powerwhenever AC power is available. Specifically, when AC power issufficiently available, an OUT port of battery management IC 1522 of thepower manager 550 is active. This allows DC power, taken directly fromAC-to-DC converter module 1520 and applied to the battery management IC1522, to be applied to the OUT port of the battery management IC 1522and applied to the voltage converters 1526, 1528. As previouslydescribed, the voltage converters 1526, 1528 apply the incoming 15 voltsignal to the utility module by way of the DC-to-DC converter 1526stepping down the incoming 15 volts to a voltage level of 5 volts andDC-to-DC converter 1528 stepping down the incoming 15 volt power to avoltage level of 3.3 volts.

However, if sufficient AC power is not available, the battery managementIC 1522 of the power management module switches the supply of power tothe utility module from DC power taken directly from the AC-to-DCconverter module to the smart battery pack 1518. Specifically, when ACpower is not sufficiently available, the OUT port of the batterymanagement IC 1522 goes low and the B (or battery) port of the batterymanagement IC 1522 goes high. This causes battery discharge switch 1524to allow charge from smart battery pack 1518 to pass through the batterydischarge switch 1524 to supply voltage converters 1526, 1528 with thevoltage required for the DC-to-DC converters to step down the incomingvoltage into 5V and 3.3 volt levels required to power the utilitymodule, as previously described.

Additionally, the battery management IC 1522 charges the battery at asuitable rate. This IC is also used to protect the battery and theutility modules from over-voltage, under-voltage, and over-current. Thecharging voltage and current ratings can be selected by SMBUS protocolwhich provides the interface with the module processor 1510. The batterymanagement IC may also have a feature to discharge the battery even ifAC power is present.

The battery management IC 1522 may charge the battery based onwell-known current or time methods of charging. If the battery isheavily discharged, it may be desirable to initially charge the batteryat a rate that is different from the normal rate of charge of thebattery. Advantageously, the battery management IC may be configured topre-charge the battery at a predetermined rate which may be safer for alow or dry charge battery before charging the battery a secondpredetermined rate which may be at a faster rate, for example. Powermanager 550 shown in the illustrative embodiment of FIG. 28 may furtherinclude battery authentication and security schemes. Power manager mayalso be configured to allow power from a defibrillator to charge thesmart battery pack when AC power is unavailable and the charge in energystorage device 415 of the defibrillator of FIG. 4 is available for thispurpose.

A utility module defibrillator assembly 1600 is shown in FIG. 29 with autility module 1608 including a bridge back 1609 to provide data and/orpower to a defibrillator 1606. Alternatively, the utility module mayprovide data and/or power to the defibrillator without the use of thebridge back as described further later below. In either and otherembodiments, the utility module provides a docking station for receivingand holding and for providing data and/or power to the defibrillator.More particularly, as shown, defibrillator 1606 may include a carryingand maneuvering handle 1605 so that a user or installer may place thedefibrillator atop (i.e., along an upper portion of) utility module1608. Connecting the utility module to the defibrillator are data cable1610 and RS232 compliant connector 1612, which may be, for instance, aDb-9 connector. More specifically, the data cable 1610 is provided witha data connector 1612 that mates with a data connector on the back sideof the defibrillator 1606 when the defibrillator is placed atop theutility module 1608 and pushed back against the bridge 1609 in order tobring the data connectors of the bridge and the defibrillator intomating engagement.

Power to the defibrillator is supplied by power cord 1614 and groundedAC power socket connector 1616. More specifically, the power connector1616 mates with a power connector on the back side of the defibrillatorwhen the defibrillator is placed atop the utility module and pushed backagainst the bridge 1610 in order to bring the power connectors of thebridge and the defibrillator into mating engagement. As described withrespect to FIG. 28, AC power connector 1616 may be a three-prong ACsocket connector that is inserted into a suitably designed portion ofthe bridge back 1609, e.g., a reversible snap-fit receptacle. RS232compliant connector 1612 may also be specially designed to fit into asnap-fit receptacle on the bridge back. Power is routed to the AC powerconnector 1616 through power cord 1614 from the power manager 550 (seeFIG. 28). Data is routed to RS232 compliant connector 1612 though datacable 1610 from the module processor.

Defibrillator 1606 rests atop the utility module and is connected viathree thumb screws (not shown) that are inserted from the bottom of theutility module and through threaded receptacles (not shown) defined inthe utility module. The threaded receptacles defining orifices 1620 onthe top and like orifices on the bottom of the utility module are forthe thumb screws to pass there through. A portion of each thumbscrewthat emerges from the top of the utility module through orifices 1620 isreceived by threaded receptacles provided on the bottom of thedefibrillator for holding the defibrillator and utility module in athreaded engagement. As previously discussed in connection with FIG. 5,the fan 506 internal to the utility module 455 provides circulating airto cool the components internal to the utility module 455 and to cool adocked defibrillator. As shown in FIG. 29, a grill 1618 defined in theutility module provides a passageway for the cooling of thedefibrillator by the fan residing in the utility module. Thedefibrillator may also be provided with a grill along the side of thedefibrillator that sits atop the utility module such that the grillaligns with grill 1618 of the utility module when the defibrillator isproperly seated. The defibrillator grill provides a passageway for thecool air from utility module to enter inside the defibrillator toprovide cooling.

Advantageously, this or other kind of fastening mechanism may also beused to connect additional utility modules in a stacking arrangement asshown in FIG. 30. FIG. 30 depicts an exploded view of an assembly of thedefibrillator 1606 of FIG. 29, utility module 1608 with bridge back 1609shown apart therefrom, and a plurality of utility modules 1658, 1659.The utility modules may each have a different parameter module, i.e., aphysiological sensor or device for sensing a physiological parameter ofa patient, such as the concentration of CO₂ in the patient's exhaustbreath, the patient's ECG symptoms, and so forth. As shown in FIG. 30,to connect each of these modules to each other in a bundled utilitymodule arrangement each of utility modules 1608, 1658, 1659 may beprovided with threaded receptacles 1621 defining orifices along the topand bottom sides of each utility module so that three thumb screws 1622,1624, 1626 may be used to threadingly connect each of utility modules1608, 1658, and 1659 to each other and to the defibrillator in avertical stacked arrangement. The thumb screws may be provided withsmall D-ring handles 1660 for easy hand-threading into mating threads(not shown) in the bottom of the defibrillator.

In the configuration shown in FIG. 30, the top-most utility moduleincludes the bridge back 1609 (shown set-back from the utility module)but the bridge back is actually connected to the utility module in thisillustrative example either by an attachment mechanism (such as byscrews) or by an integrated utility module—bridge back casing. Aspreviously discussed, the bridge back holds the data and powerconnectors to route data and power from utility module 1608 to thedefibrillator. Illustratively, this top-most utility module may bedesignated as the host utility module since it may be designed tocontrol the communications between the defibrillator and the utilitymodule and to manage the other tasks in the stacked bundled utilitymodule arrangement including the bidirectional communication between thebundled utility module and an external device as previously described.In another configuration, the utility module 1608 may be designed toserve as a host but be provided without the bridge back. In this case,data communications between the host utility module and thedefibrillator may occur through a data communication link establishedbetween an RS232 port or wireless chipset residing in the defibrillatorand a communication module residing in utility module 1608. Thecommunication module may illustratively be of the kind shown ascommunication module 490 in FIG. 4. The power to the defibrillator inthis case may be provided by an AC power cord that comes with thedefibrillator and that may be connected to AC out plug 1530 (shown inFIG. 29) residing in utility 1608. Alternatively, the AC power cord ofthe defibrillator may be connected to another AC outlet.

In another configuration, the utility module 1608 may be provided withthe bridge back 1609 but be designated to serve as a client utilitymodule to one of the other utility modules 1658 or 1659 one of which inthis example may serve as the host utility module in that stackedarrangement.

The utility modules, whether one or more, enable valuable coaching to beprovided to the defibrillator such as through one or more parametermodules (460 in FIG. 4) residing in one or more of the utility modules,one or more other modules residing in one or more of the utilitymodules, or through one or more external devices that may provide thedefibrillator with data through one or more of the utility modulesacting as proxy for the rescuer to use in a defibrillation process. Thedata from parameter modules such as data concerning the carbon dioxidein the patient's breath, a heart rate or other heart parameter, bloodpressure, and so forth may include the data previously described inconnection with the other FIGS. above. Advantageously, the use of morethan one utility module configured in a stacked arrangement as describedin FIG. 30, a daisy-chain arrangement as shown in FIG. 33, or in anyother arrangement enable more data to be made available to the rescuer;thereby enhancing the effectiveness of the defibrillation process.

In the illustrative embodiment of a bundled utility module in a stackedarrangement as shown in FIG. 30, illustratively utility modules 1658,1659 serve as the client utility modules. As a client they could haveall of the functionalities of the host utility module 1608. However, thedisclosed bundled utility module advantageously enables utility modulesthat are designed to serve only as client utility modules to includeonly a subset of or some functionality other than may be provided by thehost utility module 1608. In this way, a user may mix and matchdifferent client utility modules with a predefined utility module inorder to provide the robustness and functionality required by thebundled utility module. For more on the advantages of the disclosedbundled solution, refer to the discussion above in connection with FIG.10B where module cartridges having the same or different functionalitiesmay be inserted into receptacles defined in a utility module to enableone utility module to provide a bundled utility module solution.

In the vertical stacked arrangement of utility modules shown in FIG. 30,the modules 1658, 1659 may be interconnected for power and data asdescribed below with respect to FIG. 33. For example, in one embodiment,each module has a three-prong power socket inlet and a three-prong powerplug outlet. The power outlet of the host utility module 1608 is usedfor powering the defibrillator as described in FIG. 29. The host utilitymodule may also be used to power utility module 1658 stacked under thehost utility module. Data communications between utility modules 1658,1659 with utility module 1608 may occur through communication module 490(provided in utility modules 1658, 1659) as described in greater detailin connection with FIG. 5.

A more detailed view of a utility module 1700 is depicted in FIG. 31.The utility module, also known as the extension module assembly,includes a front panel 1702, a bottom enclosure 1704, a top cover 1706and back bridge 1708. Bottom enclosure 1704 includes three pillars 1750(only two shown in this view) for accommodating the securing fastenersdiscussed below. Top cover 1706 includes three orifices 1707 for thefasteners. In addition, the fasteners may be secured to the utilitymodule using isolation mounts 1752. The top cover 1706 may be secured tothe bottom closure 1704 using additional fasteners 1754 (four shown) andappropriate mounts 1755 (three shown) in the bottom closure.

In this view, data cable 1710 and data connector 1712 are seen emergingfrom the inner portions of the module assembly for placement on the backbridge 1708. Cable 1710 and connector 1712 may be RS-232 compliant ormay instead conform to other accepted industry standard. Cable connectorin this embodiment is an RS-232 plug connector. Power cable 1714 is seenemerging from the inner portions for placement of power connector 1716on the back bridge 1708. In this embodiment, power connector 1716 is agrounded, three prong AC power socket cord for use in 110V U.S.applications. Other embodiments may use other standards, such as for220V in other countries.

Back bridge 1708 includes a reversible socket snap-fit mount 1722 fordata connector 1712 and also includes a reversible socket snap-fit mount1724 for power connector 1716. The reversible mounts allow the power anddata connectors to be removed from their mounts as desired and thensnapped back in when desired. Back bridge 1708 also includes a grill1720 for ventilation and heat removal, the grill assisted by theventilation fan described previously. As seen in this view, back bridge1708 includes an open area below grill 1720 and between the dovetailportions 1718 (shown on right side only) that allow the back bridge tomount to the bottom enclosure 1704. This open area allows completeaccess to the rear of the bottom enclosure and is suitable for placementof the power-and data.

The front panel 1702 of the utility module provides the front “face” ofthe module. The front panel 1702 includes an accessory or parametermodule 1732, which may have additional electronics or circuitry withinthe enclosure 1704. The front panel may also include a display 1734,which will be discussed in greater detail below with respect to FIGS.34A-34D. Front panel 1702 also provides a convenient location for Wi-Fiantenna 1736 and any additional circuitry or mounting board, such as aprinted circuit board (not shown) useful for the antenna.

Bottom enclosure 1704 provides a housing for the components of theutility module 1700. The utility module includes at least one printedcircuit board (PCB) 1740 for mounting the components of the utilitymodule. PCB 1740 may mount module processor 1742, which provides theprincipal control for the entire module. The PCB may also mount manyother components of the necessary circuitry, such as memory elements,the Wi-Fi module and the CMOS battery discussed above. Note that theadditional circuitry 1744 that may be necessary for the accessory orparameter module may be placed near PCB 1740 and module processor 1742.

It may be desirable to separate these control boards from thepower-providing and managing aspects of the utility module. Thus, abattery pack 1746 and AC-to-DC converter 1748 are placed a littlefurther away from the control boards in this embodiment. Not shown inthis view are the other power management circuits discussed above. Thusthe battery management IC, the battery discharge switch the circuitryand logic associated with these elements discussed above with respect toFIG. 28, may be placed further away from PCB 1740 and module processor1742. These circuits may reside in the areas to the top left, hidden bytop cover 1706, in this view.

Right side panel 1705 includes several useful features. Data connector1756 may be a USB connector for communicating with at least the moduleprocessor and other components of the utility module. LED display 1758includes, this embodiment, three LEDs for displaying status ofcomponents of the module. As noted above in the discussion above, theLEDs may indicate status of the Wi-Fi connection, AC/battery status, andWi-Fi signal strength. In some embodiments, one of the LEDs may be usedto indicate a status of the defibrillator when it is connected to theutility module. Switch 1760 is a cutoff switch, used to switch off awireless or Wi-Fi capability of the utility module, such as for examplein an airplane or hospital.

Another useful view of the utility module defibrillator connection 1763between the defibrillator and the utility module is depicted in FIG. 32.FIG. 32 shows data communication and power connectors 1770, 1780,respectively, in mating engagement with their counterpart connectors inthe bridge back 1765. More specifically, socket power connector 1780 andsocket data communication connector 1770, in this case a Db-9 connector,have been snapped into the bridge back and thus are relatively secureand non-moving during assembly. Heat grill 1784 is also visible in thisview.

The utility modules disclosed herein and discussed with respect to FIGS.28-32 can each be equipped with a parameter module 460 as described inFIG. 4.

It is thus clear that the utility modules or extension module assembliesdisclosed herein may vary from one embodiment to another, at leastbecause each module may include a different parameter or accessorymodule. Instead of having only a single utility module for eachdefibrillator, it may be useful instead to have more than one utilitymodule available for bundling together with a host utility module, witheach utility module having a different parameter module or in some casesoverlapping functionalities. The overlapping functionalities could allowa bundled utility module to be used with more than one patientcontemporaneously or for fail-safe redundancy purposes. For thispurpose, the disclosed utility modules can be connected in a verticalstacked arrangement as shown in FIG. 30; in a horizontal arrangement asshown in FIG. 33, or in other arrangements; whereby a single primaryutility module such as utility module may be use to provide a powersource and a data communication link with one or more other utilitymodules that are connected to the primary utility module in a bundledutility module solution.

In the embodiment shown in FIG. 33, primary or host module 1800 may beequipped with a capnography module and may connect to a second module,client module 1801, equipped with a different parameter module, such asa module equipped to measure and display an ECG. A third module, clientmodule 1802 may also be powered in this series, the third module 1802equipped with for measuring blood pressure in a non-invasive way. Themodules may communicate with each other through data communication links1806 as described in FIGS. 4, 5. The modules may be interconnected inpower through power links 1808 as described in FIGS. 4, 5. Electricalconnections 1810 may, for example, be provided by the communicationmodule 490 previously described (e.g., the pairing of defibrillator dataconnect port 440 and data outlet 475 in the case of the defibrillatorand utility module and the data communication enabled by the pair ofcommunication modules in the case of pairing of utility modules to eachother. Power connections 1812, 1814 may be provided by the pairing ofpower connect 445 and power outlet 470 as described in FIG. 4. In thisembodiment, host module 1700 receives and transmits data to thedefibrillator 1850 through the data communication link Data may alsotransferred bidirectionally between the host module 1800 and clientmodules 1801, 1802, and between the client modules 1801,1802, throughdata communication links Power may be transferred between thedefibrillator and each utility modules over the power links. In otherwords, with the defibrillator as part of the daisy chain, power from anyone of the utility modules may be used to power the defibrillator. Inaddition and alternatively power from the defibrillator may be used topower any one or more of the utility modules in the daisy chain. Primaryutility module 1800 may be powered through a battery pack or through aconvenience wall outlet, as described above. The defibrillatorillustratively receives power from AC out plug 1530 (FIG. 28) of thehost utility module 1800. Secondary utility module 1801 may be poweredthrough the power link 1808 illustratively a power cable extending fromprimary module 1800, in a manner similar to the power connection betweenthe defibrillator and the host utility module 1800. Additional AC outplugs 1530 may be provided in host utility module 1800 for this purpose.Power transfer between client utility modules may occur similarly withthe utility modules provided with an AC out plug 1530 to enable a plugfrom one utility module to plug into the AC out plug of the other. Theutility modules may also receive power from convenience outlets or anyother suitable power source.

The front panels of the utility modules were discussed above. The frontpanels may have one or more parameter or other modules integrated intothe utility module design. Alternatively, the front panels may provideone or more openings or receptacles for receipt of a parameter oraccessory module cartridge as described in connection with FIG. 10B,which may have many different health monitoring applications. Severalembodiments of front panels 1910 and depicted in FIGS. 34A-35D arediscussed here. A first embodiment is disclosed in FIG. 34A. Thisembodiment includes a capnography module 1902, used for measuring theCO₂ concentration in a patient's breath. A display 1906 in this instancedisplays two status indicators, a “five-bar” display for the strength ofthe Wi-Fi connection and a solid or 100% charged battery indication.Display 3906 may be in addition to or in place of the LED display panelon the side panel of the utility module previously described.

A second embodiment of a front panel is depicted in FIG. 34B. Thisembodiment includes a utility module 1902, also a CO₂ or capnographymodule as shown in FIG. 34A. This embodiment uses a more complex screenor display 1910. Display 1910 includes a first symbol (a wrench) whichmay indicate that the utility module needs to be serviced. The screenalso includes a symbol for the strength of the Wi-Fi connections and twobattery status indicators. The fourth symbol resembles a front face of adefibrillator and indicates that the utility module is in communicationwith a defibrillator and is exchanging information with thedefibrillator.

FIG. 34C includes yet another embodiment, this one with an ECG parametermodule 1912 and two separate displays 1914, 1916. First display 1914indicates “OK” for service parameters and gives a five-bar Wi-Fi signalstrength. Second display 1916 may be a separate display showinginformation on the smart battery pack discussed above, the screenshowing full charge on two batteries and also suggesting a that there isa connection with defibrillator as shown by a very tiny icon above thebattery status indicators. Finally, FIG. 34D depicts a front panel withan ECG accessory module 1912 and a display 1918. Screen 1918 is somewhatlarge and includes icons or symbols for four status indicators. Theseinclude “OK” indicating that the utility module is in good workingorder, a high signal strength for the Wi-Fi connection, full charge fortwo batteries and an indicator showing that the utility module is inconnection with its defibrillator. FIGS. 34A-D thus provide illustrativeexamples of information that may be displayed on a utility module ofthis disclosure to help in a defibrillation process.

In connection with FIG. 10B, it was discussed how a single utilitymodule may be provided with more than one receptacle to receive morethan one utility module cartridge in order to boost the functionalityand/or robustness of a utility module. In FIGS. 34A-D, it is also seenhow a single utility module may be provided with a parameter or othermodule in a more integrated design since in these figures the parametermodules are shown integrated; albeit they could just as well becartridges received by a receptacle in the utility module. In addition,it will appreciated that the face of the utility module shown in FIGS.34A-D may include either one or more integrated parameter orfunctionality modules or one or more module cartridges that may bereceived by one or more receptacles defined by the utility module asdescribed in FIG. 10B. Alternatively, the utility module may be providedwith both one or more parameter or functionality modules that have beenintegrated into the utility module and that are received by the utilitymodule as cartridges in a pick and play fashion. It will also beappreciated that the face of the utility module can be changed-out toaccommodate different parameter or functionality modules or cartridgesor to contain other information. For instance, the face of a utilitymodule that is designed for one parameter module may at a later date bechanged out for a face that is designed for two parameter modules. Thisfeature creates even more versatility in how the disclosed utilitymodule may be customized for individual applications.

The present disclosure also includes a connection method 1950 shown inFIG. 35 for connecting one or more utility modules to the defibrillatorso that coaching may be provided to the defibrillator. The method startsat step 1952. At step 1954, a defibrillator is placed atop a hostutility module. The defibrillator is then pushed 1956 back against abridge back of a utility module to engage power and data connections toenable the defibrillator to be powered by the utility module and toenable the bidirectional flow of data between the host utility moduleand the defibrillator. At step 1958, a determination is made whether thedefibrillator will be used with one or a plurality of utility modules.If only one utility module will be used, at step 1960, thumb screws orfasteners may be used to fasten the defibrillator to the host utilitymodule and the method is ended 1979.

If at step 1957, it is determined that more than one utility module willbe used with the defibrillator, such as the client modules discussedabove, at step 1962 the additional modules are added to the host utilitymodule by vertically stacking the one or more client modules under thehost utility module. At step 1964, the client utility modules andutility module are fastened to the defibrillator as previously describedusing thumb screws or fasteners. At step 1966, the client utilitymodules are then connected to the host utility module for power, orpower may be connected from another source. At step 1968, the clientutility modules are connected to the host utility module with datacables and connectors and the method is ended 1970. The utility modulesare now ready to coach the defibrillator when a person is in need ofmedical treatment requiring a defibrillator.

There is thus disclosed a utility module with the ability bothcommunicate directly with the defibrillator and external devices and toserve as a proxy for both the defibrillator and external devices. Bothabilities allows for more effective coaching both from the utilitymodule and from external resources through the utility module. Theability of the utility module to connect external devices to adefibrillator makes the utility module a powerful vehicle forintegrating external devices to a defibrillator that is being used atthe scene in a defibrillation procedure. Through this integration, oneor more external devices may be brought to the site of a defibrillationto observe and participate in the process. Through this disclosure,external devices are enabled to provide real time coaching to a user ofa defibrillator during a defibrillator process. The inclusion of anetwork of resources in the defibrillation process further enables amore holistic approach to be brought to the defibrillation process ascompared to conventional approaches which are largely a private affairbetween the rescuer and the patient. The disclosed utility module anddefibrillator system makes possible the virtual participation of anetwork of resources in a defibrillation process.

Through this disclosure, external devices are also educated with patientand other data obtained during and in connection with the defibrillationprocess for use in post-defibrillation procedures, coaching education,historical studies, and other purposes. In addition, the ability of theutility module to itself directly communicate with the defibrillatorenables greater participation of rescuers at the site of thedefibrillation process. For example, where space constraints limit thenumber of rescuers that may be present in the locus of thedefibrillator, the utility module provides a second locus that isdistributed from the defibrillator but nonetheless in seamlesscommunication with the defibrillator; thereby allowing rescuers whomight otherwise be excluded from the process because of spacelimitations to participate in the defibrillation process. In these andother configurations, the disclosed utility module is seen to provideenhanced coaching and enhanced functionality to the defibrillatorthrough the disclosed system. In addition, the utility module anddefibrillator system of this disclosure enables external devices toprovide defibrillators with a reserve of power to enable defibrillatorsto be used where power is unavailable or when the defibrillator'sbattery power is depleted and to enable defibrillators to delivermultiple charges more readily anywhere, anytime.

In this description, numerous details have been set forth in order toprovide a thorough understanding. In other instances, well-knownfeatures have not been described in detail in order to not obscureunnecessarily the description.

A person skilled in the art will be able to practice the presentinvention in view of this description, which is to be taken as a whole.The specific embodiments as disclosed and illustrated herein are not tobe considered in a limiting sense. Indeed, it should be readily apparentto those skilled in the art that what is described herein may bemodified in numerous ways. Such ways can include equivalents to what isdescribed herein. In addition, the invention may be practiced incombination with other systems. The following claims define certaincombinations and subcombinations of elements, features, steps, and/orfunctions, which are regarded as novel and non-obvious. Additionalclaims for other combinations and subcombinations may be presented inthis or a related document.

1. A method for enhancing a defibrillation process involving adefibrillator including an energy storage device for storing anelectrical charge and a defibrillator processor, the method comprising:defining a receptacle in a first utility module for receipt of a modulefor performing a predetermined functionality in an electrical connectionconfigured to enable data communication between the functionality moduleand the first utility module; inserting the functionality module intothe receptacle to enable the data communications between thefunctionality module and the first utility module; connecting the firstutility module to a defibrillator to enable data in the datacommunications from the functionality module to the first utility moduleto be received by the defibrillator.
 2. The method of claim 1 whereinthe functionality module is a parameter module configured to detect aparameter of a patient.
 3. The method of claim 1 further comprising thesteps of: connecting the first utility module to a second utility moduleto enable data communications from the second utility module to betransmitted to the first utility module and the defibrillator.
 4. Themethod of claim 3 wherein the second utility module is electricallyconnected to the first utility module in a vertical stacked arrangement.5. The method of claim 3 wherein the second utility module iselectrically connected to the first utility module in a daisy chainarrangement.